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DiversityNursing Blog

Violence Intervention Programs 'Could Save Hospitals Millions'

Posted by Erica Bettencourt

Wed, Jan 28, 2015 @ 10:46 AM

Written by James McIntosh

man receiving therapy from a therapist with clipboard resized 600

While violence intervention programs have demonstrated that they can be an effective way of preventing violent injury, little has been known about their financial implications. A new study now suggests that these interventions could save various sectors millions of dollars.

Researchers from Drexel University have analyzed the cost-benefit ratio of hospital-based violence intervention programs (HVIPs) and report that - as well as benefiting victims' lives - HVIPs can make costs savings of up to $4 million over a 5-year period in the health care and criminal justice sectors.

"This is the first systematic economic evaluation of a hospital-based violence intervention program, and it's done in a way that can be replicated as new evidence emerges about the programs' impacts across different sectors," states lead author Dr. Jonathan Purtle.

As a major cause of disability, premature mortality and other health problems worldwide, HVIPs have a crucial role to play in helping victims from experiencing further suffering.

The provision of case-management and counseling from combinations of medical professionals and social workers has been associated with not only reducing rates of aggressive behavior and violent re-injury but also improving education, employment and health care utilization for service users.

Many HVIPs still require a sustainable source of funding

Intervention typically begins in the period immediately after a violent injury has been sustained. Not only is this a critical moment in terms of physical health, but it can also be a time when victims may start thinking about retaliation or making changes in their lives.

"The research literature has poetically referred to the time after a traumatic injury as the 'golden hour,'" says study co-author Dr. Ted Corbin.

In 2009, around six programs were in operation and, as word of their success has spread, more and more HVIPs have been initiated.

Calculating the potential financial benefits of HVIPs is crucial, as for many of these programs a stable and sustainable source of funding does not exist. Instead, many rely on a variety of different financial sources such as insurance billing, institutional funding, local government funding and private grants.

For the study, published in the American Journal of Preventive Medicine, the researchers conducted a cost-benefit analysis simulation in order to estimate what savings an HVIP could make over 5 years in a hypothetical population of 180 violently injured patients. Of these, 90 would receive HVIP intervention and 90 would not.

Costs, rates of violent re-injury and violent perpetration incidents that a population would be estimated to experience were calculated by the authors using data from 2012.

The authors made a comparison between the estimated costs of outcomes that would most likely be experienced by the 90 hypothetical patients receiving HVIP intervention - including $350,000 per year costs of the HVIP itself - and the costs of outcomes predicted for 90 patients not receiving any HVIP intervention.

The net benefit of the interventions

A total of four different simulation models were constructed by the researchers to estimate net savings and cost-benefit ratios, and three different estimates of HVIP effect size were used.

Costs that were factored into the simulations included health care costs for re-injury, costs to the criminal justice system if the victims then became perpetrators and societal costs for potential loss of productivity.

Each simulation calculated that HVIPs produced cost savings over the course of 5 years. The simulation model that only included future health costs for the 90 individuals and their potential re-injury produced savings of $82,765. The simulation model including all costs incurred demonstrated savings of over $4 million.

Dr. Purtle acknowledges that estimated lost productivity costs may have been slightly high due to an assumption in their data that all individuals in the simulation were employed. However, he believes that there are also many social benefits to HVIPs that cannot be financially quantifiable:

"Even if the intervention cost a little more than it saved in dollars and cents to the health care system, there would still be a net benefit in terms of the violence it prevented."

The authors believe that the findings of their study could be useful in informing public policy decisions. By demonstrating that HVIPs can be financially beneficial, the study suggests that an investment in HVIPs is one that pays off for everyone concerned.

Source: www.medicalnewstoday.com

Topics: injury, violence, intervention, programs, financial, victims, saving money, nursing, health, healthcare, nurse, nurses, doctors, medical, patients, hospital, treatment, Money

Psychological interventions a boon for patients with heart disease

Posted by Alycia Sullivan

Wed, Oct 16, 2013 @ 02:39 PM

Psychological interventions reduce by half deaths and cardiovascular events in patients with heart disease, according to a data analysis.

“The nurses on our coronary care unit observed that patients were less likely to have another heart attack, die or return to hospital when we talked to them about their treatment, played music for them or helped religious patients to say prayers,” Zoi Aggelopoulou, RN, PhD, a study author from NIMTS Veterans Hospital Athens in Greece, said in a news release. “It made us think that coronary heart disease is not just physical but also has a psychological component.

“We wanted to find out if others had observed the same thing, and whether psychological support had a real impact on the outcomes of patients with coronary heart disease.”

As presented in Madrid at the annual meeting of the Acute Cardiovascular Care Association of the European Society of Cardiology, researchers conducted a meta-analysis of nine randomized controlled trials that had been published previously. They evaluated whether psychological interventions could improve outcomes of patients with coronary heart disease when combined with a conventional rehabilitation program.

The researchers found the addition of psychological interventions reduced mortality and cardiovascular events by 55% after two years or more. The benefits were not significant during the first two years.

“We found a huge benefit of psychological interventions after two years, with less patients dying or having a cardiovascular event and therefore fewer repeat hospital visits,” Aggelopoulou said in the news release. “The interventions included talking to patients and their families about issues that were worrying them, relaxation exercise, music therapy and helping them to say prayers."

The researchers concluded psychological interventions should be incorporated into the rehabilitation of patients with coronary heart disease. “More clinical trials are needed to clarify which interventions are most effective and how they can best be implemented,” Aggelopoulou said in the news release.

“We can help our patients by simply talking to them or introducing new things like music therapy into our clinical practice,” she added. “Coronary units are busy places — in Greece we sometimes have one to two nurses for 10 to 20 patients in the coronary care unit, and we are under time pressure.

“But our finding that the addition of psychological support on top of physiological therapies reduces death and cardiovascular events by 55% should be a wakeup call that these interventions really do work. Preventing repeat hospital visits would free up the time we need to implement them.” 

Source: Nurse.com

Topics: intervention, psychological, cardiovascular, coronary, benefit, reduce

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