THE FINANCIAL IMPACT OF INTENTIONAL VIOLENCE ON COMMUNITY HOSPITALS

The purpose of this study was to examine the financial impact of assau lt-related penetrating trauma. We specifically reviewed hospital charg es and reimbursement data. Two hundred eleven patients were identified from our Trauma Registry in a 4-year period: 108 with firearm injurie s and 103 with injuries related to cutting or piercing instruments. As sault-related penetrating injuries generated more than $2,000,000 in h ospital charges. Sixty-seven percent of this amount was incurred by pa tients who had no source of third-party payment. Reimbursement covered only 30% of charges. There were no differences in demographics, proce dures, or in insurance status, mean charges, and unpaid balances betwe en patients directly admitted and those transferred from other hospita ls. Financial losses incurred by community hospitals from the care of penetrating injuries are substantial, and must be borne by cost shifti ng or other strategies. No evidence of ''dumping'' was found among thi s group of patients. The specter of injury caused by intentional viole nce extends beyond urban trauma centers, and has a serious negative fi nancial impact on community trauma centers.