Long-term evaluation of a hospital-based violence intervention program using a regional health information exchange

Teresa M. Bell, Dannielle Gilyan, Brian A. Moore, Joel Martin, Blessing Ogbemudia, Briana E. McLaughlin, Reilin Moore, Clark Simons, Ben L. Zarzaur

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

BACKGROUND Hospital-based violence intervention programs (HVIP) aim to reduce violent-injury recidivism by providing intensive case management services to high-risk patients who were violently injured. Although HVIP have been found effective at reducing recidivism, few studies have sought to identity how long their effects last. Additionally, prior studies have been limited by the fact that HVIP typically rely on self-report or data within their own healthcare system to identify new injuries. Our aim was to quantify the long-term recidivism rate of participants in an HVIP program using more objective and comprehensive data from a regional health information exchange. METHODS The study included 328 patients enrolled in Prescription for Hope (RxH), an HVIP, between January 2009 and August 2016. We obtained RxH participants' emergency department (ED) encounter data from a regional health information exchange database from the date of hospital discharge to February 2017. Our primary outcome was violent-injury recidivism rate of the RxH program. We also examined reasons for ED visits that were unrelated to violent injury. RESULTS We calculated a 4.4% recidivism rate based on 8 years of statewide data, containing 1,575 unique encounters. More than 96% of participants were matched in the state database. Of the 15 patients who recidivated, only five were admitted for their injury. More than half of new violence-related injuries were treated outside of the HVIP-affiliated trauma center. The most common reasons for ED visits were pain (718 encounters), followed by suspected complications or needing additional postoperative care (181 encounters). Substance abuse, unintentional injuries, and suicidal ideation were also frequent reasons for ED visits. CONCLUSION The low, long-term recidivism rate for RxH indicates that HVIPs have enduring positive effects on the majority of participants. Our results suggest that HVIP may further benefit patients by partnering with organizations that work to prevent suicide, substance use disorders, and other unintentional injuries. LEVEL OF EVIDENCE Therapeutic study, level III.

Original languageEnglish (US)
Pages (from-to)175-182
Number of pages8
JournalJournal of Trauma and Acute Care Surgery
Volume84
Issue number1
DOIs
StatePublished - Jan 1 2018

Fingerprint

Violence
Wounds and Injuries
Hospital Emergency Service
Substance-Related Disorders
Hope
Databases
Suicidal Ideation
Health Information Exchange
Postoperative Care
Trauma Centers
Case Management
Self Report
Suicide
Prescriptions
Organizations
Delivery of Health Care
Pain

Keywords

  • hospital-based violence intervention
  • injury recidivism
  • Violence prevention

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Bell, T. M., Gilyan, D., Moore, B. A., Martin, J., Ogbemudia, B., McLaughlin, B. E., ... Zarzaur, B. L. (2018). Long-term evaluation of a hospital-based violence intervention program using a regional health information exchange. Journal of Trauma and Acute Care Surgery, 84(1), 175-182. https://doi.org/10.1097/TA.0000000000001671

Long-term evaluation of a hospital-based violence intervention program using a regional health information exchange. / Bell, Teresa M.; Gilyan, Dannielle; Moore, Brian A.; Martin, Joel; Ogbemudia, Blessing; McLaughlin, Briana E.; Moore, Reilin; Simons, Clark; Zarzaur, Ben L.

In: Journal of Trauma and Acute Care Surgery, Vol. 84, No. 1, 01.01.2018, p. 175-182.

Research output: Contribution to journalArticle

Bell, Teresa M. ; Gilyan, Dannielle ; Moore, Brian A. ; Martin, Joel ; Ogbemudia, Blessing ; McLaughlin, Briana E. ; Moore, Reilin ; Simons, Clark ; Zarzaur, Ben L. / Long-term evaluation of a hospital-based violence intervention program using a regional health information exchange. In: Journal of Trauma and Acute Care Surgery. 2018 ; Vol. 84, No. 1. pp. 175-182.
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abstract = "BACKGROUND Hospital-based violence intervention programs (HVIP) aim to reduce violent-injury recidivism by providing intensive case management services to high-risk patients who were violently injured. Although HVIP have been found effective at reducing recidivism, few studies have sought to identity how long their effects last. Additionally, prior studies have been limited by the fact that HVIP typically rely on self-report or data within their own healthcare system to identify new injuries. Our aim was to quantify the long-term recidivism rate of participants in an HVIP program using more objective and comprehensive data from a regional health information exchange. METHODS The study included 328 patients enrolled in Prescription for Hope (RxH), an HVIP, between January 2009 and August 2016. We obtained RxH participants' emergency department (ED) encounter data from a regional health information exchange database from the date of hospital discharge to February 2017. Our primary outcome was violent-injury recidivism rate of the RxH program. We also examined reasons for ED visits that were unrelated to violent injury. RESULTS We calculated a 4.4{\%} recidivism rate based on 8 years of statewide data, containing 1,575 unique encounters. More than 96{\%} of participants were matched in the state database. Of the 15 patients who recidivated, only five were admitted for their injury. More than half of new violence-related injuries were treated outside of the HVIP-affiliated trauma center. The most common reasons for ED visits were pain (718 encounters), followed by suspected complications or needing additional postoperative care (181 encounters). Substance abuse, unintentional injuries, and suicidal ideation were also frequent reasons for ED visits. CONCLUSION The low, long-term recidivism rate for RxH indicates that HVIPs have enduring positive effects on the majority of participants. Our results suggest that HVIP may further benefit patients by partnering with organizations that work to prevent suicide, substance use disorders, and other unintentional injuries. LEVEL OF EVIDENCE Therapeutic study, level III.",
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