Accessibility and Use of Violence Intervention Programs: A Retrospective Analysis of the National American College of Surgeons Committee on Trauma Firearm Study Research Dataset.

Abstract

Violence intervention programs (VIPs) have emerged as a promising strategy to mitigate adverse outcomes for individuals affected by firearm violence. This study aims to compare patient populations between facilities that offer VIP services and those that do not while also identifying factors associated with VIP use. A retrospective cohort analysis was conducted using the National American College of Surgeons Committee on Trauma Firearm Study Research Dataset. Adult patients were categorized on the basis of the availability of VIP services at their treating facility and, within VIP facilities, by whether they received VIP services. Differences in demographics and injury characteristics were analyzed using t -tests and Pearson chi-square tests. Multivariable logistic regression was performed to identify independent predictors of VIP use. Among 15,455 patients, 9,942 (64.3%) were treated at VIP facilities, whereas 5,513 (35.7%) were treated at non-VIP facilities. Patients at non-VIP facilities were older (mean age: 30.3 vs 29.8 years, p = 0.027) and more often Black (64.3% vs 60.7%, p < 0.001). Within VIP facilities, 8,101 (81.5%) did not receive VIP services, whereas 1,841 (18.5%) received VIP services. Patients who received VIP services were younger (mean age: 27.84 vs 30.25, p < 0.001), more often Black (72.8% vs, 58.0%, p < 0.001), and using Medicaid (55.2% vs, 45.4%, p < 0.001). Assault-related injury was the strongest predictor of VIP service use (odds ratio 3.00, 95% CI 1.50 to 5.99, p = 0.002). At hospitals that offer VIP services, patients with assault-related injury, Black patients, those with Medicaid, and individuals with a history of mental illness are more likely to receive VIP services. Non-VIP facilities treat a substantial number of high-risk patients, yet these patients lack access to these interventions.