Research indicates that young people who are violently injured by stabbing or gunshot are nearly twice as likely to have a subsequent violent injury requiring hospital treatment within two years compared to their counterparts with non-violent injuries. Hospital-based Violence Intervention Programs (HVIPs) were first established in the United States in the 1990s in response to the rate of homicide in the category of youth and young adults. A unique feature of HVIPs is the public health lens through which programs operate. Like other public health issues, violent injury has identifiable factors that put people at risk or offer protection. HVIPs operate on the basis that there is a “golden moment” window of opportunity to effectively engage with victims of violent injury while they are recovering in the hospital. In this moment, and with the aid of a case manager, patients may reconsider their current pathway and gain access to community supports that enable new pathways to healthy outcomes. HVIPs reduce health care costs by decreasing recidivism to the hospital and reduces other societal costs by decreasing involvement with the justice system. Compared to the direct healthcare costs to treat violently injured patients, evidence-based early intervention programs are a small cost with an excellent return on investment. Program operations are primarily based on salary support of a culturally-competent case manager who has personal experience with community violence. Case management thresholds should be established to maintain reasonable expectations.
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