Hospital-based violence intervention programs: An analysis of costs and key components

Abstract

BACKGROUND Firearm assaults contribute to nearly 18,000 deaths and at least twice as many injuries annually, with immense human and financial costs. Gun violence survivors especially face unique and long-term physical, mental, economic, and safety-related challenges. Hospital-based violence intervention programs (HVIPs) connect survivors with violence prevention professionals at their hospital bedsides, then provide them with wraparound services in the months to come. Promising research shows that HVIPs reduce risks of reinjury, retaliation, and recidivism. METHODS This report provides a cost analysis of HVIPs, to inform researchers and implementers of the budget and key resources necessary for the first three years of implementation. Researchers employ an ingredients-based costing approach and base-case assumptions for a hospital-linked HVIP situated in a mid-sized city emergency department, serving 100 participants annually. RESULTS Results indicate that this base-case HVIP costs an estimated $1.1 million annually, or just under $10,800 per participant. Staffing accounts for the majority of HVIP budgets, followed by operations, crisis support, and finally transportation. Upfront costs are limited to technical assistance, first-time equipment, and accreditation courses, leaving annual costs relatively stable across the first 3 years of implementation. A customizable workbook is provided, through which users can adjust this study’s assumptions to reflect their own program’s specifications, which may vary. CONCLUSION While a full cost-savings analysis remains needed, HVIP enrollment costs less per person than a single year of medical fees for nonfatal firearm assault-related injuries. This research can inform future cost, benefit, and savings analyses, and empower more communities to implement lifesaving HVIPs. LEVEL OF EVIDENCE Economic and Value-Based Evaluation; Level II.