Domestic violence: variation in case-management by the general practitioner in Belgium.

OBJECTIVES: to describe the medical interventions and referrals carried out by the general practitioner (GP) when taking care of victims and to quantify the between-physician variability in management of domestic violence.

METHODS: A nationwide sentinel network of 150 general practitioners, covering 1.5 % of the Belgian population, registered in 2002-2004 all episodes of domestic violence for which they were consulted, via paper registration forms. A multilevel analysis was carried out by fitting a random effects logistic regression model for every intervention/referral.

RESULTS: The most frequent interventions of the GP were providing a certificate of injury (54 %), and making an appointment for a next visit (33 %). Half of the patients were referred or hospitalised upon the first consultation, most frequently they were advised to go to the police (17 %) or referred to a psychologist or psychiatrist (11 %). The intra cluster correlation coefficient (ICC) of the interventions varied between 11 % and 39 % and the median odds ratios between 1,82 and 3,96.

CONCLUSIONS: GP consultations for domestic violence are frequent and involve considerable between-physician variability in care.