{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T18:04:13Z","timestamp":1770919453804,"version":"3.50.1"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T00:00:00Z","timestamp":1695859200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p>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\u201335). 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\u2019 first report of trafficking occurred most often outside of a hospital or emergency setting (55%), primarily during office and psychiatric visits.<\/jats:p>","DOI":"10.3389\/fpubh.2023.1243413","type":"journal-article","created":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T12:56:41Z","timestamp":1695905801000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Victims of human trafficking and exploitation in the healthcare system: a retrospective study using a large multi-state dataset and ICD-10 codes"],"prefix":"10.3389","volume":"11","author":[{"given":"Alexander","family":"Gutfraind","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kezban","family":"Yagci Sokat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guido","family":"Muscioni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sami","family":"Alahmadi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Hudlow","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald","family":"Hershow","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beau","family":"Norgeot","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,9,28]]},"reference":[{"key":"ref1","year":"2000"},{"key":"ref2","year":"2017"},{"key":"ref3","year":"2021"},{"key":"ref4","year":"2022"},{"key":"ref5","author":"Clawson","year":"2009"},{"key":"ref6","volume-title":"The commercial sexual exploitation of children in the US, Canada and Mexico","author":"Estes","year":"2001"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/23322705.2020.1815474","article-title":"An epidemiological perspective on labor trafficking","author":"Gallo","year":"2020","journal-title":"J Hum Traffick"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1017\/S2045796016000135","article-title":"Prevalence and risk of violence and the mental, physical and sexual health problems associated with human trafficking: an updated systematic review","volume":"25","author":"Ottisova","year":"2016","journal-title":"Epidemiol Psychiatr Sci"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e008682","DOI":"10.1136\/bmjopen-2015-008682","article-title":"Human trafficking and health: a cross-sectional survey of NHS professionals\u2019 contact with victims of human trafficking","volume":"5","author":"Ross","year":"2015","journal-title":"BMJ Open"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"6","DOI":"10.3389\/fpubh.2015.00006","article-title":"Health care providers and human trafficking: what do they know, what do they need to know? 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