Hospital violence intervention programmes improve emergency department identification of attendances

Abstract Background Violence affects individuals, communities and additionally impacts hospitals and Emergency Departments (EDs). Patients can be unwilling to disclose that their injury is violence-related, limiting opportunities to address any underlying psychosocial vulnerabilities. Using a public health approach, Hospital-based Violence Intervention Programmes (HVIPs) have been implemented in two South Wales hospitals to address violence-related attendances. We assessed the extent that the additional resource provided by HVIPs can overcome barriers to disclosure compared to usual care and the characteristics of patients unwilling to disclosure under usual care. Methods Routine healthcare data from intervention (n = 2) and control (n = 9) EDs linked with census data. Multi-level logistic difference in difference models considered allocation on the probability an unplanned attendance was categorised as assault-related. Secondary analysis considered the associations between age, ethnicity [ETC] on whether ARA was missed under usual care for intervention sites. Results The presence of a HVIP in the ED increased the probability of an ARA classification (Cardiff β = 0.37, 95% CI 0.31 to 0.44; Swansea β = 0.19, 95% CI 0.14 to 0.25). Patients missed under usual care were younger, male, of black or mixed ethnicity and resided in areas of greater deprivation. Conclusions When patients do not disclose that their injury is violence-related they may be at risk of not getting support for related psychosocial vulnerabilities. The additional resource of a HVIP in two EDs improved the identification of assault-related attendances and may therefore overcome healthcare inequalities associated with protected characteristics. Key messages • The presence of a HVIP increases the likelihood that patients exposed to violence will receive a code for an assault-related attendance. • HVIPs may provide additional support for any underlying psychosocial vulnerabilities potentially impacting on health inequalities in Emergency Care.