Providing Acute Care to Sexual Assault Patients in NYC: Addressing Issues of Access and Quality

Aims: This study aimed to determine the availability and accessibility of sexual assault forensic services in NYC's emergency departments and the quality of care from the sexual assault patient's viewpoint.

Methods: To measure the availability of sexual assault forensic services, Emergency Department (ED) Directors and staff were interviewed at 39 of the 63 emergency departments in NYC. Accessibility data was collected from a sample of EDs on the number of sexual assault patients per year and if these patients walked-in or were transported via ambulance. An anonymous satisfaction survey was also administered via rape crisis programs and online to sexual assault patients, which asked about their experiences with acute hospital care after the assault.

Results: We found that which emergency department you go to in NYC is likely to determine the quality of care you receive after a sexual assault. The most comprehensive care is provided to sexual assault patients in emergency departments with Sexual Assault Forensic Examiner (SAFE) programs, however these programs were not always accessible to survivors due to city rules on the transportation of patients via ambulance. Many survivors also reported that they did not receive adequate medical care and follow-up from the hospital. Only 52% of survivors surveyed reported that the health clinician gave them information about HIV post-exposure prophylaxis.

Conclusion:

The implications of this study on development of city policy and hospital practices to ensure quality and availability of acute sexual assault services will be discussed.