Family, Domestic and Sexual Violence Presentations to a Virtual Emergency Department: A Retrospective Cohort Study

BACKGROUND: Family, domestic and sexual violence (FDSV) is a global health issue affecting one in four women. Emergency departments (EDs) are often the first point of healthcare contact for people experiencing FDSV. Virtual emergency departments have been introduced in Australia to improve access to care and reduce pressure on physical EDs, but little is known about FDSV presentations in this setting. This study aimed to identify and describe FDSV presentations to the Victorian Virtual Emergency Department (VVED). METHODS: A retrospective cohort study examined FDSV presentations to VVED between 1 July 2023 and 30 June 2024. Cases were identified using VVED, injury surveillance, and clinician documentation data. Records were filtered by age, sex and injury intent, followed by file review to confirm eligibility. Demographic and presentation characteristics were summarised using descriptive statistics. RESULTS: Twenty-one FDSV presentations were identified among 173,936 VVED presentations (0.012%). All were female, median age 37 years. Most were born in Australia (86%) and lived in socioeconomically disadvantaged areas (62%). Intimate partner violence was the most common form of FDSV (81%), and injuries above the clavicle (head, face and neck injuries) were the most frequent presentation (53%). Most patients were referred via healthcare professionals (76%). One-third were directed to physical EDs, while most were managed virtually with follow-up arranged through general practitioners or other healthcare providers. CONCLUSIONS: FDSV presentations were rarely identified in the virtual emergency setting, suggesting under-detection. Virtual EDs offer opportunities to support people experiencing violence, but improved clinician training, documentation and referral pathways are needed.