142nd APHA Annual Meeting and Exposition

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299472
A Cost-Benefit Analysis Simulation of a Hospital-Based Violence Intervention Program

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Jonathan Purtle, DrPH, MPH, MSc , Department of Health Management & Policy, Drexel University School of Public Health, Philadelphia, PA
Linda Rich, MA , Emergency Medicine, Drexel University College of Medicine, Philadelphia, PA
John Rich, MD, MPH , Department of Health Management & Policy, Drexel University School of Public Health, Philadelphia, PA
Sandra Bloom, MD , Health Management & Policy, Drexel University School of Public Health, Philadelphia, PA
Theodore Corbin Jr., MD, MPP , Department of Emergency Medicine, Drexel University College of Medicine, Philadelphia, PA
Background/Purpose: Violent injury is a recurrent problem with a 5-year reinjury rate as high as 45%. Evidence suggests that hospital-based violence intervention programs (HVIPs) prevent violent reinjury and violent perpetration, but little is known about their cost-benefits. We conducted a cost-benefit analysis simulation to estimate an HVIPs impact on health care, criminal justice, and lost productivity costs.

Methods: We used primary data on HVIP costs and drew from secondary data sources to estimate the cost, number, and type of violent reinjury incidents (fatal/nonfatal, requiring hospitalization/not requiring hospitalization) and violent perpetration incidents (aggravated assault/homicide) that a hypothetical population would experience over 5 years with and without HVIP intervention. We constructed four different models using three estimates of HVIP effect size (20%, 25%, 30%) to calculate a range of estimates for HVIP net savings and cost-benefit ratios from different payer perspectives. All benefits were discounted at 5%.

Results/Outcomes: Assuming that an HIVP costs $3,889 per patient and reduces violent re-injury/violent perpetration by 25%, an HVIP was projected to produce net savings of $82,759 in health care costs over five years when only violent re-injury was included in the model, $109,441 in health care costs when injuries resulting from violent perpetration were added, $225,291 when criminal justice costs were added, and $3,940,737 when lost productivity costs were included.

Conclusions: HVIPs have potential to serve as a cost-effective model for violent injury prevention. This study provides the first systematic framework for the economic evaluations of HVIPs and offers a foundation for future research.

Learning Areas:

Administration, management, leadership
Conduct evaluation related to programs, research, and other areas of practice
Public health administration or related administration
Public health or related public policy
Public health or related research

Learning Objectives:
Describe the cost-benefits of hospital-based violence intervention programs from different payer perspectives given different estimates and assumptions Discuss gaps in violent injury research that need to be addressed in order for economic evaluations of violent injury prevention programs to be more methodologically robust Design a framework for conducting the economic evaluation of an injury prevention program

Keyword(s): Youth Violence, Evaluation

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present this paper because I have a DrPH in Health Management & Policy, an MPH,six years progressive research experience research and evaluation for a hospital-based violence intervention program, and the Manager of the Policy Workgroup of the National Network of Hospital-based Violence Intervention Programs, have presented at APHA before and published in peer-review journals on topics related to violent injury prevention.
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.

Back to: 3305.0: Violence-related injuries