Measuring the quality of medical care for women who experience sexual assault with data from the National Hospital Ambulatory Medical Care Survey

Abstract

Study Objective: We provide new descriptive epidemiology on the demography and quality of care of women who experience sexual assault. Two limited aspects of emergency department treatment received by women who have experienced sexual assault are examined: (1) administration of emergency contraception to prevent pregnancy and (2) screening and treatment for sexually transmitted diseases (STDs). Methods: A nationally representative survey on the basis of 7 years of data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) was analyzed. Estimates of mean numbers of patients treated and characteristics of patients are reported for administration of emergency contraception and compliance with STD guidelines. Results: Analysis shows that the number of rapes per year reported in the NHAMCS data is highly consistent with the number of forcible rapes reported by the Federal Bureau of Investigation. Results show statistically significant differences in patients who receive screening on the basis of age and also suggest that the same difference exists for STD medications received. Accounting for differences in screening and medications by age does not completely explain why a large portion of the patients are neither screened nor receive STD medications. Conclusion: Women are not receiving the full complement of treatment, as suggested by the Centers for Disease Control and Prevention guidelines. Administration of emergency contraception is less frequent in the NHAMCS sample than in hospitals with a sexual assault treatment program that report administration of emergency contraception. It is important to assess care for patients experiencing sexual assault in a nationally representative sample to identify deficiencies in treatment and areas in need of improvement. [Amey AL, Bishai D. Measuring the quality of medical care for women who experience sexual assault with data from the National Hospital Ambulatory Medical Care Survey. Ann Emerg Med. June 2002;39:631-638.]