Diagnoses, Classifications and Codes: Gender-based violence in administrative health data

Olive, Philippa (2012) Diagnoses, Classifications and Codes: Gender-based violence in administrative health data. In: British Sociological Association Annual Conference, 2012-04-11 - 2012-04-13. (Unpublished)

Abstract

Gender-based violence against women is recognized worldwide as a major public health issue associated with poor health experiences, greater health ‘need’ and greater health contacts. In England, NHS health services have been named as sites of intervention for forms of gender-based violence against women. ‘Intervention’ is concerned with ‘identification’ and care management. This research project focuses on the emergency department as a site of intervention to investigate how ‘domestic violence’, a form of gender-based violence, is constructed during health contacts in emergency departments in the North West of England. In order to inform the sample design for the research project, International Classification of Disease (ICD-10) and Accident and Emergency (A&E) diagnostic taxonomies were examined to establish the ways ‘domestic violence’ may be classified in administrative health data. Using codes from ICD-10 and A&E maltreatment and assault nomenclatures, data was obtained from Hospital Episodes Statistics (HES) to establish rates of application in practice of clinical codes most likely to represent ‘domestic violence’. On analysis, the HES data reveals that forms of gender-based violence against women are paradoxically both present and absent in health data. Using Jutel and Nettleton’s (2011) sociology of diagnosis as a framework and preliminary findings from the broader project, this paper presents an analysis of the classifications of violence in operation and the degree of presence of gender-based violence against women in routinely collected NHS administrative health data in NHS Trusts in the North West of England.