Department of Emergency Medicine, University of Maryland School of Medicine, 6th Floor, Suite 200, 110 South Paca Street, Baltimore, MD, 21201, USA.
Youth ALIVE!, Oakland, CA, USA.
J Community Health. 2018 Apr;43(2):259-262. doi: 10.1007/s10900-017-0413-9.
The emergence of evidence-supported interventions allows hospitals the opportunity to reduce future reinjury among patients who are violently injured. However, hospital knowledge of these interventions and their perceived role in violence prevention is unknown. The Patient Protection and Affordable Care Act created new legal requirements for non-profit hospitals to conduct community health needs assessments (CHNA) every three years to maintain not-for-profit status. In turn, this allows an empiric evaluation of hospital recognition and response to community violence. To do so, this study performed a content analysis of hospital CHNAs from the 20 U.S. cities with the highest violent crime rates. A total of 77 CHNAs were examined for specific violence-related keywords as well as whether violence prevention was listed as a priority community need. Overall, 74% of CHNAs mentioned violence-related terms and only 32% designated violence prevention as a priority need. When discussed, 88% of CHNAs referenced community violence, 42% intimate partner or sexual violence, and 22% child abuse. This study suggests that hospitals may lack awareness of violence as an actionable, preventable public health issue. Further, evidence-based program models are available to hospitals that can reduce the recurrence of assaultive injuries.
证据支持的干预措施的出现使医院有机会减少因暴力受伤而再次受伤的患者的未来伤害。然而，医院对这些干预措施的了解及其在预防暴力方面的作用尚不清楚。《患者保护与平价医疗法案》（Patient Protection and Affordable Care Act）为非营利性医院创造了新的法律要求，要求其每三年进行一次社区健康需求评估（CHNA），以保持非营利性地位。反过来，这允许对医院对社区暴力的认识和反应进行实证评估。为此，本研究对美国暴力犯罪率最高的 20 个城市的医院 CHNA 进行了内容分析。总共检查了 77 份 CHNA，以查找特定的与暴力相关的关键词，以及是否将预防暴力列为优先社区需求。总体而言，74%的 CHNA 提到了与暴力相关的术语，只有 32%将预防暴力列为优先需求。在讨论中，88%的 CHNA 提到了社区暴力，42%提到了亲密伴侣或性暴力，22%提到了儿童虐待。本研究表明，医院可能对暴力作为可采取行动、可预防的公共卫生问题缺乏认识。此外，医院可采用循证方案模式，以减少攻击伤害的再次发生。
