The Journal of surgical research · 2026
Hospital-Based Violence Intervention Program: Impact on Post-Discharge Healthcare Engagement.
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Goldstein Carma, McCullough Mary Alyce, Saxena Richa, Oakley Emily, Avery Martin D
Аннотация
INTRODUCTION: Hospital-based violence intervention programs (HVIPs) aim to reduce reinjury and recidivism by addressing underlying determinants of violence. Despite proven benefits, their impact on post-discharge healthcare engagement remains underexplored. Our study sought to evaluate hospital system value of a newly implemented HVIP by assessing post-discharge healthcare engagement.
METHODS: A retrospective before-and-after cohort study was conducted at a level I trauma center, comparing patients admitted with penetrating firearm injuries before HVIP implementation (2022) and after HVIP implementation (2024). The post group was further stratified as those enrolled in the HVIP and those not enrolled. The primary outcome was follow-up adherence within 6 months. Secondary outcomes included other engagement within the health system.
RESULTS: Of the 167 pre-patients and 133 post-patients, scheduled follow up was documented at 98% and 90%, respectively (P = 0.002). However, among those with scheduled follow up, adherence was higher in the post group (88% versus 93%, P = 0.254). In comparing the post group enrolled in HVIP to those not enrolled in HVIP, follow-up adherence was significantly higher (100% versus 88%, P = 0.011). Medicine visits increased from 22% to 63% (P < 0.001) in the HVIP enrolled group compared to the not enrolled. No significant differences were found in surgical follow up, post discharge surgeries, or ED visits.
CONCLUSIONS: HVIP enrollment was associated with a significant improvement in follow-up adherence and engagement with primary and specialty care. This suggests that HVIPs enhance continuity and institutional value through reduction in missed appointments and strengthened care pathways. Future research should assess long term outcomes and cost effectiveness to guide health system investment.
METHODS: A retrospective before-and-after cohort study was conducted at a level I trauma center, comparing patients admitted with penetrating firearm injuries before HVIP implementation (2022) and after HVIP implementation (2024). The post group was further stratified as those enrolled in the HVIP and those not enrolled. The primary outcome was follow-up adherence within 6 months. Secondary outcomes included other engagement within the health system.
RESULTS: Of the 167 pre-patients and 133 post-patients, scheduled follow up was documented at 98% and 90%, respectively (P = 0.002). However, among those with scheduled follow up, adherence was higher in the post group (88% versus 93%, P = 0.254). In comparing the post group enrolled in HVIP to those not enrolled in HVIP, follow-up adherence was significantly higher (100% versus 88%, P = 0.011). Medicine visits increased from 22% to 63% (P < 0.001) in the HVIP enrolled group compared to the not enrolled. No significant differences were found in surgical follow up, post discharge surgeries, or ED visits.
CONCLUSIONS: HVIP enrollment was associated with a significant improvement in follow-up adherence and engagement with primary and specialty care. This suggests that HVIPs enhance continuity and institutional value through reduction in missed appointments and strengthened care pathways. Future research should assess long term outcomes and cost effectiveness to guide health system investment.