The authors wish to acknowledge John Leventhal, MD, for feedback and guidance in the implementation of the study. This research has been supported in part by the National Heart, Lung and Blood Institute (NHLBI), supplement to U01/HL-04-001 (Training Core–Resuscitation Research). This study was previously presented at the Society for Academic Emergency Medicine Western Regional Research Forum in Park City, Utah, in January 2009, and at the Society for Academic Emergency Medicine Annual Assembly in New Orleans, Louisiana, in May 2009. For further information, contact: Esther K. Choo, MD, Department of Emergency Medicine, Rhode Island Hospital, Alpert Medical School of Brown University, 593 Eddy Street, Claverick 2nd floor, Providence, RI 02903; e-mail echoMD@gmail.com.
Rural-Urban Disparities in Child Abuse Management Resources in the Emergency Department
Article first published online: 6 JUL 2010
© 2010 National Rural Health Association
The Journal of Rural Health
Volume 26, Issue 4, pages 361–365, Fall 2010
How to Cite
Choo, E. K., Spiro, D. M., Lowe, R. A., Newgard, C. D., Hall, M. K. and McConnell, K. J. (2010), Rural-Urban Disparities in Child Abuse Management Resources in the Emergency Department. The Journal of Rural Health, 26: 361–365. doi: 10.1111/j.1748-0361.2010.00307.x
- Issue published online: 6 JUL 2010
- Article first published online: 6 JUL 2010
- Access to care;
- child abuse;
- emergency medicine;
- health disparities;
- health services research
Purpose: To characterize differences in child abuse management resources between urban and rural emergency departments (EDs).
Methods: We surveyed ED directors and nurse managers at hospitals in Oregon to gain information about available abuse-related resources. Chi-square analysis was used to test differences between urban and rural EDs. Multivariate analysis was performed to examine the association between a variety of hospital characteristics, in addition to rural location, and presence of child abuse resources.
Findings: Fifty-five Oregon hospitals were surveyed. A smaller proportion of rural EDs had written abuse policies (62% vs 95%, P= .006) or on-site child abuse advocates (35% vs 71%, P= .009). Thirty-two percent of rural EDs had none of the examined abuse resources (vs 0% of urban EDs, P= .01). Of hospital characteristics studied in the multivariate model, only rural location was associated with decreased availability of child abuse resources (OR 0.19 [95% CI, 0.05-0.70]).
Conclusions: Rural EDs have fewer resources than urban EDs for the management of child abuse. Other studied hospital characteristics were not associated with availability of abuse resources. Further work is needed to identify barriers to resource utilization and to create resources that can be made accessible to all ED settings.