Injury Recidivism Rate and Cost Analysis - An estimate of the long term costs of violent injury

For every homicide, an additional 100 people are violently injured in the United States. An estimate of the long term costs of violent injury is $264 billion yearly. Our level I trauma center's violence prevention program (VPP) is designed to reduce our preprogram injury recidivism rate of 36.6%. The purpose of this study was to evaluate the VPP recidivism rate and conduct a cost-analysis comparing VPP programmatic cost to cost associated with treating interpersonal violent injury. We hypothesize that the VPP reduces recidivism and provides cost-savings in public dollars.

Using the Microsoft randomization feature, we evaluated medical and financial information on 100 violently injured individuals who met our VPP eligibility criteria. Costs were then expanded to estimate for the entire eligible population in that year. We converted hospital charge data to total direct cost (cost to charge ratio). VPP annual budget includes salaries, travel and supplies. The three-year recidivism rate of the VPP was calculated. Extrapolated costs determined potential savings of an expanded VPP.

Total hospital cost of the 100 subjects was $4,860,000. Average cost was $49,000. Our VPP recidivism rate was 11% (N=145). The VPP served 58 clients in 2007 with a budget of $168,000. The table demonstrates current savings and expanded savings using an extrapolated cost model with an 11% recidivism rate. Eighty-three percent of our victims were uninsured or insured by public funding sources such as Medicaid.

Recidivism was reduced substantially from historical figures. If we prevent just 3.5 re-injuries, our VPP would be cost neutral. If we expand we could save $2.6 million, mostly in taxpayer dollars. Violence prevention should be part of the fabric of trauma centers. It reduces recidivism and is cost effective by saving public funds.