Speaker
Description
Authors: Megan Hamilton (Cardiff University), Adele Battaglia (Public, Patient Involvement Lay Member), Daniel Tod (Swansea University), Henry Yeomans (Public, Patient Involvement Lay Member), Jonathan Shepherd (Cardiff University), Lara Snowdon (Public Health Wales), Shainur Premji (University of York), Simon Moore (Cardiff University)
Presenter/ Corresponding Author: Megan Hamilton, Simon C. Moore
Background: Violence has been declared a public health issue, affecting people and communities with additional impact on hospitals and Emergency Departments (EDs). Patients who are unwilling to disclose that their attendance is violence related may be unlikely to receive support for linked psychosocial vulnerabilities. Hospital-based Violence Intervention Programmes (HVIPs) have been implemented in EDs to address violence-related attendances. We aimed to assess whether HVIPs can overcome barriers of patient disclosure and characteristics of patients that may be more susceptible to non-disclosure under usual care.
Methods: A multi-level logistic difference in difference model was utilised using unplanned ED attendances on the probability that an attendance was recorded as an assault related attendance or whether these later appeared as an ARA in the HVIP data. Nine control EDs from Wales (UK) were compared with two intervention sites with nurse-led HVIPs (Cardiff and Swansea, Wales). Secondary analysis was conducted to assess the characteristics of patient who disclose to the HVIP but who do not disclose under usual care.
Public and patient involvement and engagement (PPIE) informed this study.
Results: The probability that an attendance was registered as an assault-related attendance increased in EDs where a HVIP was implemented (Cardiff β = 0.37, 95% CI 0.31 to 0.44; Swansea β = 0.19, 95% CI 0.14 to 0.25). Those missed under usual care were those who were male, younger, of black or mixed ethnicity and were from more deprived areas.
Discussion: Lack of disclosure may lead patients to not getting the support for related psychosocial vulnerabilities. HVIPs can improve ascertainment whilst reaching patients groups that are missed under usual care due to lack of disclosure. HVIPs offer the prospect of reducing health inequalities in patients’ attending ED due to violence allowing more patients to be prevented from taking part in violence through support for psychosocial vulnerability.
Conflicts of Interest:
Prof Simon C. Moore has also received grants from the Medical Research Council, Office of the South Wales Police and Crime Commissioner and the National Institute for Health and Social Care Research outside of the current work.
| Conflict of interest | Prof Simon C. Moore has also received grants from the Medical Research Council, Office of the South Wales Police and Crime Commissioner and the National Institute for Health and Social Care Research outside of the current work. |
|---|
