Chong Vincent E, Smith Randi, Garcia Arturo, Lee Wayne S, Ashley Linnea, Marks Anne, Liu Terrence H, Victorino Gregory P
Department of Surgery, Highland Hospital, University of California, San Francisco-East Bay, 1411 East 31st Street, QIC 22134, Oakland, CA 94602, USA.
Youth ALIVE!, 3300 Elm Street, Oakland, CA, USA.
Am J Surg. 2015 Apr;209(4):597-603. doi: 10.1016/j.amjsurg.2014.11.003. Epub 2014 Dec 18.
Hospital-centered violence intervention programs (HVIPs) reduce violent injury recidivism. However, dedicated cost analyses of such programs have not yet been published. We hypothesized that the HVIP at our urban trauma center is a cost-effective means for reducing violent injury recidivism.
We conducted a cost-utility analysis using a state-transition (Markov) decision model, comparing participation in our HVIP with standard risk reduction for patients injured because of firearm violence. Model inputs were derived from our trauma registry and published literature.
The 1-year recidivism rate for participants in our HVIP was 2.5%, compared with 4% for those receiving standard risk reduction resources. Total per-person costs of each violence prevention arm were similar: $3,574 for our HVIP and $3,515 for standard referrals. The incremental cost effectiveness ratio for our HVIP was $2,941.
Our HVIP is a cost-effective means of preventing recurrent episodes of violent injury in patients hurt by firearms.
以医院为中心的暴力干预项目（HVIPs）可降低暴力伤害再发率。然而，此类项目专门的成本分析尚未发表。我们推测，我们城市创伤中心的HVIP是降低暴力伤害再发率的一种具有成本效益的手段。
我们使用状态转换（马尔可夫）决策模型进行了成本效用分析，将参与我们的HVIP与因枪支暴力受伤患者的标准风险降低措施进行比较。模型输入数据来自我们的创伤登记处和已发表的文献。
我们HVIP参与者的1年再发率为2.5%，而接受标准风险降低资源的参与者为4%。每个暴力预防方案的人均总成本相似：我们的HVIP为3574美元，标准转诊为3515美元。我们HVIP的增量成本效益比为2941美元。
我们的HVIP是预防枪支伤害患者暴力伤害复发的一种具有成本效益的手段。
