An assessment of the direct costs of healthcare for victims of sexual assaults in hospital emergency units

Background. - The Forensic medicine reform in 2011 enabled the development of forensic units specialized in multidisciplinary care of victims of criminal offences. Thanks to an annual budgetary allocation, the Ministry of Justice handles the financing of judicial acts, while the health care facilities assume the medical, psychological and social aspects. The objective of this study was to determine the direct costs of medical care provided to rape victims (such as defined in the article 222-23 of the Penal Code) in order to see how its funding could be reconsidered to prevent any additional cost that could be caused by non-sufficient medical, psychological and social care. Furthermore, this first assessment may serve as a basis for further reflection on creating other medical judicial units but also for reviewing existing structures. Methods. - The direct costs for medical care of a recent rape victim (< 48 hours) was quantified by including staff and consumables costs, treatments, biological tests and other expenses. Results. - The overall time for the entire medical care procedure was approximately three hours, for an overall cost of 673.92 (SIC), of which 41.5 % (279.90 (SIC)) was paid by the Ministry of Justice. The medical, psychological and social aspects stood for the major expenditure items (394.02 (SIC)), attributable mainly to the biological screening tests for sexually transmissible infections (STIs). Conclusion. - These frequent situations require the convergence of human and material needs with a financial burden shared between the Ministry of Justice and health establishments. Authors suggest that in the annual hospital budgetary allocation allotted by the Ministry of Justice, the care of victims of sexual assault be based on the rate of day hospitalization "Medicine, medical specialties part time day or night common regime'', allowing to provide optimal multidisciplinary care, which lessens the risks of complications and reduces the global cost created by these situations. (C) 2018 Published by Elsevier Masson SAS.