Disparities in the investigation of reported physical abuse among adult trauma patients in the United States.

BACKGROUND

Among trauma patients with suspected physical abuse, investigation often depends on clinician recognition and institutional practices. We aimed to identify patient and hospital-level factors associated with investigation of reported physical abuse.

METHODS

We used the 2017-2019 ACS-TQIP database to identify trauma patients ≥18 years with documented physical abuse and stratified them by whether an abuse investigation was initiated. Investigation was defined as a formal evaluation by a qualified team member or external service. Multivariable logistic regression identified predictors of investigation.

RESULTS

Of 27,985 patients, 82.7 ​% underwent investigation. Hispanic ethnicity, non-private insurance, penetrating injury, severe abdominal injury, and treatment at mid-sized hospitals were associated with increased odds of investigation. In contrast, Black race and admission to teaching hospitals and level II/III trauma centers were associated with decreased odds.

CONCLUSIONS

Significant disparities exist in the investigation of reported abuse, emphasizing the need for standardized protocols to ensure equitable care.