title: Interpersonal violence: quantifying the burden of injury in a South African trauma centre.
abstract: BACKGROUND
  Interpersonal violence is an epidemic in South Africa and remains an under-reported and expensive burden on health resources. In most of the developing world there is little or no descriptive information about the expense of treating the consequences of interpersonal violence.
  
  
  OBJECTIVE
  To review the direct burden of interpersonal violence on a tertiary hospital in Northern KwaZulu-Natal, an area known to have high rates of poverty and violent crime.
  
  
  METHODS
  A retrospective case note review of emergency hospital admissions between January and March 2013 was carried out. The reports included demographic characteristics, admitting diagnosis and surgical management. Case files were reviewed to determine cost drivers, such as radiological investigations, blood products, theatre usage and specialist care.
  
  
  RESULTS
  Trauma accounted for 374 hospital admissions from the emergency department, of which 142 (38%) were attributable to interpersonal violence (16% of total admissions). One hundred and fifty-six hospital bed days were used over the study period. The average inpatient stay was 9.8 days with 58% requiring a resuscitation bed on admission. One-third of patients underwent emergency surgery and eight patients required postoperative intensive care. The minimum hospital expenditure for interpersonal violence injuries over 3 months was R8 367 788 ($783 960).
  
  
  CONCLUSIONS
  Interpersonal violence is the source of a significant financial burden on the South African health system. Patients are often severely injured and require a high level of specialist investigations and surgical care. This study gives evidence to improve budget and workload planning for regional surgical departments and supports the need for more effective primary prevention.
authors.affiliation: Department of Surgery, Ngwelezane Hospital, Empangeni, KwaZulu-Natal, South Africa.
authors.forename: Sumrit
authors.initials: S
authors.lastname: Bola
authors.affiliation: Department of Surgery, Ngwelezane Hospital, Empangeni, KwaZulu-Natal, South Africa.
authors.forename: Isabella
authors.initials: I
authors.lastname: Dash
authors.affiliation: Department of Surgery, Ngwelezane Hospital, Empangeni, KwaZulu-Natal, South Africa.
authors.forename: Maheshwar
authors.initials: M
authors.lastname: Naidoo
authors.affiliation: Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Colleen
authors.initials: C
authors.lastname: Aldous
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D017721:Hospital Costs; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012151:Resuscitation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013019:South Africa / Q000453:epidemiology; D062606:Tertiary Care Centers / Q000191:economics / Q000706:statistics & numerical data; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014754:Violence / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult
keywords: Trauma; cost effectiveness; emergency care systems, remote and rural medicine; imaging; violence, interpersonal