Unmet health care needs among children evaluated for sexual assault

Objectives: To determine in a population of children who underwent a medical examination after alleged sexual assault the proportion who had unmet medical or psychiatric needs. Design: Retrospective medical record review. Setting: A referral center for alleged child victims of sexual assault in Houston, Tex, from December 1, 2003, through April 30, 2004. Participants: Four hundred seventy-three children (81% girls). Nine children refused all or part of the medical evaluation. Main Outcome Measure: Diagnoses that warranted intervention at the time of the medical evaluation. Results: A medical or psychological diagnosis that required intervention as judged by the examiner was made in 123 children (26%) (95% confidence interval, 22%-30%). In 39 children (8% of the total study population) (95% confidence interval, 6%-11%), the diagnosis had the potential to result in significant patient morbidity if not immediately addressed. In contrast, 44 children (9%) (95% confidence interval, 7%-12%) had probable or definite physical or laboratory evidence that supported the allegation of sexual assault. Conclusion: Among children undergoing a medical evaluation after an alleged sexual assault, important unmet health care needs are at least as common as forensic findings.