Victims of human trafficking and exploitation in the healthcare system: a retrospective study using a large multi-state dataset and ICD-10 codes
Trafficking and exploitation for sex or labor affects millions of persons worldwide. To improve healthcare for these patients, in late 2018 new ICD-10 medical diagnosis codes were implemented in the US. These 13 codes include diagnosis of adult and child sexual exploitation, adult and child labor ex...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1243413/full |
| _version_ | 1797671588553818112 |
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| author | Alexander Gutfraind Alexander Gutfraind Alexander Gutfraind Kezban Yagci Sokat Guido Muscioni Sami Alahmadi Jonathan Hudlow Ronald Hershow Beau Norgeot |
| author_facet | Alexander Gutfraind Alexander Gutfraind Alexander Gutfraind Kezban Yagci Sokat Guido Muscioni Sami Alahmadi Jonathan Hudlow Ronald Hershow Beau Norgeot |
| author_sort | Alexander Gutfraind |
| collection | DOAJ |
| description | Trafficking and exploitation for sex or labor affects millions of persons worldwide. To improve healthcare for these patients, in late 2018 new ICD-10 medical diagnosis codes were implemented in the US. These 13 codes include diagnosis of adult and child sexual exploitation, adult and child labor exploitation, and history of exploitation. Here we report on a database search of a large US health insurer that contained approximately 47.1 million patients and 0.9 million provider organizations, not limited to large medical systems. We reported on any diagnosis with the new codes between 2018-09-01 and 2022-09-01. The dataset was found to contain 5,262 instances of the ICD-10 codes. Regression analysis of the codes found a 5.8% increase in the uptake of these codes per year, representing a decline relative to 6.7% annual increase in the data. The codes were used by 1,810 different providers (0.19% of total) for 2,793 patients. Of the patients, 1,248 were recently trafficked, while the remainder had a personal history of exploitation. Of the recent cases, 86% experienced sexual exploitation, 14% labor exploitation and 0.8% both types. These patients were predominantly female (83%) with a median age of 20 (interquartile range: 15–35). The patients were characterized by persistently high prevalence of mental health conditions (including anxiety: 21%, post-traumatic stress disorder: 20%, major depression: 18%), sexually-transmitted infections, and high utilization of the emergency department (ED). The patients’ first report of trafficking occurred most often outside of a hospital or emergency setting (55%), primarily during office and psychiatric visits. |
| first_indexed | 2024-03-11T21:17:43Z |
| format | Article |
| id | doaj.art-3cd0c9b73fe54cbd97f3756e443bb7a3 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-03-11T21:17:43Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-3cd0c9b73fe54cbd97f3756e443bb7a32023-09-28T12:56:30ZengFrontiers Media S.A.Frontiers in Public Health2296-25652023-09-011110.3389/fpubh.2023.12434131243413Victims of human trafficking and exploitation in the healthcare system: a retrospective study using a large multi-state dataset and ICD-10 codesAlexander Gutfraind0Alexander Gutfraind1Alexander Gutfraind2Kezban Yagci Sokat3Guido Muscioni4Sami Alahmadi5Jonathan Hudlow6Ronald Hershow7Beau Norgeot8Carelon Inc., Indianapolis, IN, United StatesDepartment of Medicine, Loyola University Chicago School of Medicine, Maywood, IL, United StatesDivision of Epidemiology and Biostatistics, University of Illinois School of Public Health, Chicago, IL, United StatesMarketing and Business Analytics, San Jose State University, San Jose, CA, United StatesCarelon Inc., Indianapolis, IN, United StatesGeorgetown University, Washington, DC, United StatesLove Justice International, Lincoln, NE, United StatesDivision of Epidemiology and Biostatistics, University of Illinois School of Public Health, Chicago, IL, United StatesCarelon Inc., Indianapolis, IN, United StatesTrafficking and exploitation for sex or labor affects millions of persons worldwide. To improve healthcare for these patients, in late 2018 new ICD-10 medical diagnosis codes were implemented in the US. These 13 codes include diagnosis of adult and child sexual exploitation, adult and child labor exploitation, and history of exploitation. Here we report on a database search of a large US health insurer that contained approximately 47.1 million patients and 0.9 million provider organizations, not limited to large medical systems. We reported on any diagnosis with the new codes between 2018-09-01 and 2022-09-01. The dataset was found to contain 5,262 instances of the ICD-10 codes. Regression analysis of the codes found a 5.8% increase in the uptake of these codes per year, representing a decline relative to 6.7% annual increase in the data. The codes were used by 1,810 different providers (0.19% of total) for 2,793 patients. Of the patients, 1,248 were recently trafficked, while the remainder had a personal history of exploitation. Of the recent cases, 86% experienced sexual exploitation, 14% labor exploitation and 0.8% both types. These patients were predominantly female (83%) with a median age of 20 (interquartile range: 15–35). The patients were characterized by persistently high prevalence of mental health conditions (including anxiety: 21%, post-traumatic stress disorder: 20%, major depression: 18%), sexually-transmitted infections, and high utilization of the emergency department (ED). The patients’ first report of trafficking occurred most often outside of a hospital or emergency setting (55%), primarily during office and psychiatric visits.https://www.frontiersin.org/articles/10.3389/fpubh.2023.1243413/fullhuman traffickingsexual exploitationlabor exploitationprimary careICD-10insurance claims |
| spellingShingle | Alexander Gutfraind Alexander Gutfraind Alexander Gutfraind Kezban Yagci Sokat Guido Muscioni Sami Alahmadi Jonathan Hudlow Ronald Hershow Beau Norgeot Victims of human trafficking and exploitation in the healthcare system: a retrospective study using a large multi-state dataset and ICD-10 codes Frontiers in Public Health human trafficking sexual exploitation labor exploitation primary care ICD-10 insurance claims |
| title | Victims of human trafficking and exploitation in the healthcare system: a retrospective study using a large multi-state dataset and ICD-10 codes |
| title_full | Victims of human trafficking and exploitation in the healthcare system: a retrospective study using a large multi-state dataset and ICD-10 codes |
| title_fullStr | Victims of human trafficking and exploitation in the healthcare system: a retrospective study using a large multi-state dataset and ICD-10 codes |
| title_full_unstemmed | Victims of human trafficking and exploitation in the healthcare system: a retrospective study using a large multi-state dataset and ICD-10 codes |
| title_short | Victims of human trafficking and exploitation in the healthcare system: a retrospective study using a large multi-state dataset and ICD-10 codes |
| title_sort | victims of human trafficking and exploitation in the healthcare system a retrospective study using a large multi state dataset and icd 10 codes |
| topic | human trafficking sexual exploitation labor exploitation primary care ICD-10 insurance claims |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1243413/full |
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