Characteristics, costs, and effects of violence in Vermont

Study of the distribution, characteristics, costs and effects involving 125 assaults, 22 attempted suicides (plus 5 completed out-of-hospital suicides), and 49 injuries of questionable intent was carried out among local area patients treated in a hospital serving 22 communities (150,000 population) in northern Vermont. Patients referred from the service areas of other hospitals were specifically excluded in order to provide a picture of injuries from violence in the community, rather than of injuries treated at the hospital. The percentages hospitalized were assault, 5%; attempted suicide, 50%; and unknown intent, 6%. Most assault injuries were to the head or upper extremity administered by fist; suicide attempts most often were by medication or a sharp instrument to arms, while injuries of unknown intent usually resulted from smashing a hand against a building structure. Alcohol use was noted for 26%, 38%, and 23% of patients aged 15 years or older in the three respective categories. Average hospital charges (excluding physicians' bills) for the three respective injury events were $420, $2639, and $388. Only 2% of hospital bills were paid by patients or their families, 25% were paid by commercial insurance, 19% by government sources, and 54% remained unpaid. One eighth of physicians' bills for hospital and followup care were paid by patients or their families, and about 60% were still unpaid a year after billing. Among assault patients who could be contacted for followup and who had been employed or in school previously, 27% had no disability for work or school and the remainder averaged 18 days of complete plus partial disability.