Assessing the Extent of Provision of Comprehensive Medical Care Management for Female Sexual Assault Patients in US Hospital Emergency Departments.

OBJECTIVE:To describe medical services provided to sexual assault patients in US emergency departments and to identify the percentage of hospitals always providing the 10 elements of comprehensive medical care management (CMCM).METHODS:A cross-sectional study was conducted in a national sample of US hospitals. A 26-item telephone survey assessed provision of services to sexual assault survivors in accordance with CMCM. Management included acute medical care comprising history and physical examination; acute and long-term rape crisis counseling; STI testing and prophylaxis; emergency contraception counseling and provision; and HIV testing and prophylaxis. The primary outcome was extent of provision of these elements.RESULTS:Overall, 582 emergency departments responded to the survey. The following components of CMCM were provided: acute medical care (582 [100.0%]); rape crisis counseling (234 [40.2%]); STI management (448 [77.0%]); emergency contraception (351 [60.3%]); and HIV management (380 [65.3%]). Only 101 (17.4%) hospitals provided all 10 elements of CMCM.CONCLUSION:Less than one-fifth of US hospitals provide comprehensive services to sexual assault patients. A national program incorporating clinical guidelines, checklists, and funding for sexual assault forensic/nurse examiner programs could improve the standard of care provided in emergency departments-the primary point of contact for acute care of sexual assault survivors.