Pre-screening for elder abuse in sanglah general hospital, denpasar, Bali

Abstract

Objectives: To identify clinically elderly individuals with elevated risk of being abused based on risk factors and potential forensic markers present. Methods: The design was a cross-sectional analysis of de-identified data taken from the medical database of Sanglah General Hospital, Denpasar. Participants were individuals aged 60 and above with specific ICD-10 coding indicating potential correlates of abuse reported in Sanglah General Hospital over a 6 year period (N = 898). Measured were participant characteristics include demographic characteristics, management and method of payment. The presence of four risk factors and seven potential forensic markers identified using ICD-10 codes were taken and summed. Analytic statistics was used for analysis. Results: Approximately two-thirds of participants were between ages 60-74, 51% were male, 87% received out-patient treatment and 85% used state insurance. 13% had multiple potential correlates of abuse. Five elders were coded with history of assault, with a further 5 coded for abuse. In logistic regression, four predictors, cognitive impairment, functional dependency, fracture and multiple injuries were identified. However only multiple injuries (P=0.008) was significantly associated with multiple risk factors and potential forensic markers of elder abuse. Conclusion: Given the ability of forensic markers to identify elder abuse strongly, it is important to further screen elderly patients who present with multiple injuries. More research is needed to further identify forensic markers of elder abuse valid within the Indonesian clinical context.