Non-fatal violence-related injuries (VRIs) at the Kingston Regional Hospital (KRH): a preventable drain on resources [Abstract]

ABSTRACT

OBJECTIVE: We used data for a one-year period from the Violence-related Injury (VRI) Surveillance System at the Kingston Regional Hospital (KRH) in Jamaica to describe the patterns of non-fatal VRIs. We also carried out simulation analysis to estimate rates of hospital admission under various injury-reduction scenarios, and the potential savings that could be realized by reducing violent crimes and the hospital care associated with them. METHOD: Data used were for the one-year period, August 1, 1998 to July 31, 1999. In this period there were 6107 registered violence-related visits to the Accident and Emergency Department (AED) of the KRH, representing 11.5 percent of all recorded visits. Questions on the form included age, gender, circumstance and method of injury, victim-perpatrator relationship, and admission status. cases are non-fatal violence-related injuries resulting from threatened or actual use of physical force with the intent to cause harm, and do not include accidental or self-inflicted injuries. Simulation results are based on predicted values of admission status following maximum likelihood multiple regression models and the appropriate manipulation of relevant independent variables. RESULTS: 16.6 percent (1001) of subjects were admitted. The most common method of inflicting injury was by stabbing, accounting for 52.1 percent of injuries. Bodily force or blunt objects accounted for another 37.9 percent, while gunshot wounds accounted 7.3 percent of injuries. Multivariate analyses indicated gumshot injuries, stab injuries, being male, between the ages of 15 and 44 years, receiving the injury in November or December, and being injured by a stranger or unknown assailant, to be significant correlates of probability of admission ranging from 12 percent to 44 percent, with estimated savings of up to 20 percent of the annual budget of KRH. CONCLUSIONS: Non-fatal VRIs compromise a significant proportion of admissions to KRH. There are predicatble correlates of the likelihood of admission, and educational drives aimed at reducing specific risk factors can lead to large savings of limited resources. (AU)