Providers spend billions of dollars preparing for and responding to violence both inside and outside of hospitals. That number includes losses from uncompensated care, added security spending and more, according to a new report.
Consulting firm Milliman analyzed (PDF) prior research and estimated that hospitals spent $2.7 billion in 2016 on both proactive and reactive violence response efforts.
The researchers divided costs into four groups: preparedness and prevention for public violence, post-incident public violence costs, preparedness and prevention for violence in healthcare facilities, and costs following a violent incident in a health facility.
Hospitals spent $1.1 billion shoring up security in their own facilities in advance of a violent incident, and about $429 million in medical care, indemnity, staffing and other costs following one. About $280 million went toward prevention programs for community violence, and the final $852 million covered uncompensated care and utilization review costs for victims of violence.
Healthcare workers are at significant risk for workplace violence—between 2011 and 2013, nearly 75% of workplace assaults took place in healthcare settings. Nurses are in particular danger. Workplace violence is also an underreported problem, and executives have been criticized for not making it easier for employees to report assaults or other incidents.
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Hospitals are also on the front lines of responding to community violence and play an important role in prevention, according to the report. AHA President Rick Pollack said in a statement that preventing violence is central to hospitals’ missions.
“Keeping people healthy is at the heart of healthcare, and violence runs counter to that,” Pollack said. “It's our hope that quantifying the resources hospitals and health systems commit illustrates the enormity of this issue as a public health problem while giving hospitals the chance to highlight their efforts to keep their communities and workplaces safer.”
The report was presented at a panel during the AHA’s leadership summit, and panelist Thomas Simon, associate director for science in the division of violence prevention at the Centers for Disease Control and Prevention, said the CDC’s model for treating violence like a public health issue offers key strategies for hospitals, reports Hospitals & Health Networks.
The CDC’s model includes four steps:
- Define the problem and monitor it by gathering data
- Identify risk factors that may make people more likely to be victims of violence, as well as protective factors that could mitigate that risk
- Use data and those factors to develop and test prevention strategies
- Push for widespread adoption of strategies that have proven effective
“Hospitals are really in a unique position ... You’ve got great infrastructure, you’ve got stability. Oftentimes in communities, the hospital is really the only organization you can say that about. You bring great credibility to the table,” Simon said at the panel. “So, there’s a real opportunity for hospitals to get involved.”