Online Program

Hospital-based violence intervention programs: Policy perspectives and potential cost savings

Tuesday, November 5, 2013

Jonathan Purtle, DrPH, MPH, MSc, Department of Health Management & Policy, Drexel University School of Public Health, Philadelphia, PA
Rochelle Dicker, MD, FACS, San Francisco Injury Center & Department of Surgery, University of California, San Francisco, San Francisco
Carnell Cooper, MD, Cowley Shock Trauma Center, University of Maryland School of Medicine, Cheverly, MD
Theodore Corbin, MD, MPP, Department of Emergency Medicine, Drexel University College of Medicine, Philadelphia, PA
Micheal Greene, PhD, Greene Consulting, ...
Anne Marks, MPP, National Network of Hospital-based Violence Intervention Programs, Youth ALIVE!, Oakland, CA
Diana Creasser, MS, RN, IU Wishard Level I Trauma Center, ...
Deric Topp, MPH, Boston University School of Public Health
Dawn Moreland, RN, BSN, MedStar Washington Hospital Center
Interpersonal violence is a recurrent problem that places financial strain on urban hospitals. In 2011, approximately 1.7 million incidents of non-sexual interpersonal violence were treated in hospitals across the United States. It is estimated that up to 45% of violently injured patients are violently re-injured within five years. The average cost of care for a violent injury requiring hospitalization is $24,350; $1,000 for a violent injury not requiring hospitalization. As a large proportion of violently injured patients are under or uninsured, hospitals are often uncompensated for the care they provide to victims of violence. With the Affordable Care Act's Medicaid expansion uncertain in some states, and cuts in disproportionate share hospital payments looming, urban hospitals have a financial incentive to prevent hospital recidivism for violent injury. Hospital-based violence intervention programs (HVIPs) offer an evidence-supported, cost-effective strategy to save lives and money.

HVIPs engage violently injured patients in hospitals, conduct needs assessments, and provide intensive case management services—connecting patients to mental health and substance misuse services, education and job training programs, and housing relocation assistance—to prevent violent re-injury. HVIPs have demonstrated effectiveness across a range of outcomes in randomized controlled evaluations. HVIPs also facilitate hospital reimbursement by assisting hard to reach patients with Medicaid and Victim Compensation Assistance enrollment and may help satisfy non-profit hospitals' community benefit requirements. There are currently more than 20 HVIPs operating across the country under the umbrella of the National Network of Hospital-based Violence Intervention Programs (NNHVIP).

This presentation, prepared by the NNHVIP Policy Workgroup, will provide hospital administrators with the knowledge and tools necessary to establish an HVIP. We will describe the empirical and theoretical foundations of the HVIP model, synthesize research on HVIP effectiveness and cost-savings, discuss strategies to obtain hospital buy-in and overcome barriers, and highlight policy priorities for HVIP sustainability.

Learning Areas:

Administer health education strategies, interventions and programs
Administration, management, leadership
Program planning

Learning Objectives:
Describe the hospital-based violence intervention program (HVIP) model. Explain the current state of evidence of regarding HVIP effectiveness. List ways in which HVIPs can produce benefits for hospitals.

Keyword(s): Youth Violence, Hospitals

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am manager of the Policy Workgroup of the National Network of Hospital-based Violence Intervention Programs. I have over 6 years progressive expedience in public health research and my current job is focused on the research and evaluation of hospital-based violence intervention programs. I have presented at APHA before and published in AJPH on issues pertaining to health care policy and racial and ethnic health disparities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.