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Hospitals face $2.7 billion in costs yearly tied to community, in-house violence

AHA says $1.1 billion from that total goes to support violence prevention and preparedness programs.

Beth Jones Sanborn, Managing Editor

The American Hospital Association has put a price tag on violence when it comes to what it costs hospitals, and it's a hefty one.

A new AHA report showed both proactive and reactive violence response efforts contributed $2.7 billion in costs for hospitals and health systems in 2016. By far, the largest share of the costs was the $1.1 billion in prevention and preparedness costs for violence within hospitals. The next biggest shares were $752 million in uncompensated medical care for victims, and an additional $429 million in medical care, staffing and other costs resulting from in-hospital incidents. Another $280 million related to preparedness and prevention for community violence.

[Also: Gun violence a public health crisis, costs hospitals $2.9 billion a year, reports say]

The study defined violence broadly as "any intentional use of physical force to cause injury or bodily harm. Figures were derived from analyzing data found in peer-reviewed literature, published reports, and primary data analysis of hospital financial statements and medical claims. Other sources contained information regarding the cost of violence to U.S. hospitals, rates of violent crime, general hospital expenditures, labor statistics, and hospital treatment costs for patients, the AHA said.

The costs were divided into four categories: Public violence costs pertaining to prevention and preparedness, deemed proactive, and post-incident costs, deemed reactive, as well as in-facility violence costs, both proactive and reactive costs.

Of the $429 million in post-in-facility incident costs, it's important to note that the largest portion of these costs, $234 million, pertained to staff turnover. An incident of violence in a medical facility can not only impact community members and patients, but also staff can be badly shaken when one of their colleagues is harmed by violence on the job. They may be traumatized and need a fresh start elsewhere, or may feel unsafe in their workplace following an incident. Employee absenteeism following a violent incident fueled almost $54 million in costs as well.

[Also: California OSHA approves rule requiring hospitals to develop violence prevention protocols]

Of the $1.1 billion spent on in-house violence prevention and preparedness, by far the largest chunk was spent on security staff and infrastructure. Far behind that, hospitals spent only $175 million on staff training and only $97.6 million on developing procedures to deal with violence. While no one would discount the importance of hospital security, one could argue that an ounce of prevention is worth a pound of cure in the sense that training staff on how to better deal with agitated patients, how to protect oneself in the face of a violent incident, and developing actionable policies and protocols that can be used to meet violence head-on might be worth more attention from hospital leadership.

Finally, when it comes to the vast measure of uncompensated care hospitals are absorbing each year, the $752 million estimate only focused on patient care expenses that were not directly reimbursed by patients or third parties like private insurance, Medicare, or Medicaid.

"This approach highlights the important role that hospitals play in bridging the gap between what patients, government, and private insurers pay and the total cost of medical care for victims of violence," the study said.

Twitter: @BethJSanborn
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