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Stephen R. Dearwater, MS; Jeffrey H. Coben, MD; Jacquelyn C. Campbell, RN, PhD; Gregory Nah, MA; Nancy Glass, RN, MSN, MPH; Elizabeth McLoughlin, ScD; Betty Bekemeier, MSN, MPH

JAMA. 1998;280:433-438.

Context.— The majority of prior studies examining intimate partner abuse in the emergency department (ED) setting have been conducted in large, urban tertiary care settings and may not reflect the experiences of women seen at community hospital EDs, which treat the majority of ED patients in the United States.

Objective.— To determine the prevalence of intimate partner abuse among female patients presenting for treatment in community hospital EDs and describe their characteristics.

Design.— An anonymous survey conducted from 1995 through 1997 inquiring about physical, sexual, and emotional abuse.

Setting.— Eleven community EDs in Pennsylvania and California.

Participants.— All women aged 18 years or older who came to the ED during selected shifts.

Main Outcome Measures.— Reported acute trauma from abuse, past-year physical or sexual abuse, and lifetime physical or emotional abuse.

Results.— Surveys were completed by 3455 (74%) of 4641 women seen. The prevalence of reported abuse by an intimate partner was 2.2% (95% confidence interval [CI], 1.7%-2.7%) for acute trauma from abuse, 14.4% (95% CI, 13.2%-15.6%) for past-year physical or sexual abuse, and 36.9% (95% CI, 35.3%-38.6%) for lifetime emotional or physical abuse. California had significantly higher reported rates of past-year physical or sexual abuse (17% vs 12%, P<.001) and lifetime abuse (44% vs 31%, P<.001) than Pennsylvania. Logistic regression modeling identified 4 risk factors for reported physical, sexual, or acute trauma from abuse within the past year: age, 18 to 39 years (odds ratio [OR], 2.2; 95% CI, 1.7-3.0); monthly income less than $1000 (OR, 1.7; 95% CI, 1.3-2.1); children younger than 18 years living in the home (OR, 2.0; 95% CI, 1.5-2.6); and ending a relationship within the past year (OR, 7.0; 95% CI, 5.5-8.9).

Conclusion.— If the prevalence of abuse in community hospitals throughout the United States is similar to the range of prevalence estimates found in this study, then heightened awareness of intimate partner abuse is warranted for patients presenting to the ED.

From the Department of Emergency Medicine, Center for Violence and Injury Control, Allegheny University of the Health Sciences, Pittsburgh, Pa (Mr Dearwater and Dr Coben); the School of Nursing, Johns Hopkins University, Baltimore, Md (Dr Campbell and Ms Glass); the San Francisco Injury Center for Research and Prevention, San Francisco, Calif (Mr Nah and Dr McLoughlin); and the Tacoma–Pierce County Health Department, Tacoma, Wash (Ms Bekemeier).

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