By Jesse J. Helton, Jason T. Carbone, et al., JAMA Pediatrics, November 4, 2019

For children who have been sexually abused, emergency department (ED) professionals provide immediate medical care, including testing and treatment for sexually transmitted infections, prophylaxis for potential HIV exposure, and emergency contraception. In some cases, ED clinicians conduct forensic examinations to assist with child protection and criminal investigations. Physicians and nurses in EDs are among the first to recognize the signs of sexual abuse and identify patients who are currently being abused, such as children being exploited in sex trafficking. Despite the medical, criminal justice, and protective roles that ED professionals serve in caring for vulnerable children, few data are available regarding the frequency with which children are admitted to the ED for sexual abuse. Therefore, this analysis observed patterns among children admitted to the ED for sexual abuse across the United States and examined important subgroup characteristics based on demographic and primary payer data.

Methods
Data from Nationwide Emergency Department Sample of the Healthcare Cost and Utilization Project4 between January 1, 2010, and December 31, 2016, were used for the analysis. The Nationwide Emergency Department Sample is based on a 20% stratified sample of hospital-based EDs and is the largest publicly available all-payer database of ED visits. This study’s sample represented 78.2% of all ED admissions in the United States and was weighted to calculate national estimates. Data were analyzed from March 1 to March 31, 2019. The Healthcare Cost and Utilization Project comprises a deidentified limited data set that adheres to the privacy guidelines of the Health Insurance Portability and Accountability Act of 1996. In addition, a data use agreement was in place between the authors and the Agency for Healthcare Research and Quality, which manages the Nationwide Emergency Department Sample. Therefore, study approval from an institutional review board was not required.

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