Hospital-centered violence intervention programs: a cost-effectiveness analysis.
BACKGROUND
Hospital-centered violence intervention programs (HVIPs) reduce violent injury recidivism. However, dedicated cost analyses of such programs have not yet been published. We hypothesized that the HVIP at our urban trauma center is a cost-effective means for reducing violent injury recidivism.


METHODS
We conducted a cost-utility analysis using a state-transition (Markov) decision model, comparing participation in our HVIP with standard risk reduction for patients injured because of firearm violence. Model inputs were derived from our trauma registry and published literature.


RESULTS
The 1-year recidivism rate for participants in our HVIP was 2.5%, compared with 4% for those receiving standard risk reduction resources. Total per-person costs of each violence prevention arm were similar: $3,574 for our HVIP and $3,515 for standard referrals. The incremental cost effectiveness ratio for our HVIP was $2,941.


CONCLUSIONS
Our HVIP is a cost-effective means of preventing recurrent episodes of violent injury in patients hurt by firearms.
Department of Surgery, Highland Hospital, University of California, San Francisco-East Bay, 1411 East 31st Street, QIC 22134, Oakland, CA 94602, USA.
Vincent E
VE
Chong
Department of Surgery, Highland Hospital, University of California, San Francisco-East Bay, 1411 East 31st Street, QIC 22134, Oakland, CA 94602, USA.
Randi
R
Smith
Department of Surgery, Highland Hospital, University of California, San Francisco-East Bay, 1411 East 31st Street, QIC 22134, Oakland, CA 94602, USA.
Arturo
A
Garcia
Department of Surgery, Highland Hospital, University of California, San Francisco-East Bay, 1411 East 31st Street, QIC 22134, Oakland, CA 94602, USA.
Wayne S
WS
Lee
Youth ALIVE!, 3300 Elm Street, Oakland, CA, USA.
Linnea
L
Ashley
Youth ALIVE!, 3300 Elm Street, Oakland, CA, USA.
Anne
A
Marks
Department of Surgery, Highland Hospital, University of California, San Francisco-East Bay, 1411 East 31st Street, QIC 22134, Oakland, CA 94602, USA.
Terrence H
TH
Liu
Department of Surgery, Highland Hospital, University of California, San Francisco-East Bay, 1411 East 31st Street, QIC 22134, Oakland, CA 94602, USA. Electronic address: gvictorino@alamedahealthsystem.org.
Gregory P
GP
Victorino
D000293:Adolescent; D002648:Child; D003362:Cost-Benefit Analysis; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D008390:Markov Chains; D012008:Recurrence; D014754:Violence / Q000191:economics* / Q000517:prevention & control*; D014948:Wounds, Gunshot / Q000191:economics* / Q000517:prevention & control*; D055815:Young Adult
Cost analysis; Hospital-based violence intervention programs; Recidivism; Trauma; Violence prevention