Hospitals spend $18.3B a year thwarting violence

Violent acts in hospitals are costing hospitals $18.3 billion a year, a new report from the American Hospital Association (AHA) found. Further, the number of incidents in the U.S. has been climbing for much of the past decade, as has the price tag for mitigation.

Looking at rates of assault, homicide, suicide and firearm violence, the AHA found all of the above were exacerbated during the COVID-19 pandemic, as seen in a spike in the total number of incidents. However, for the purpose of this report, it opted to measure how violence impacts hospitals more broadly—meaning incidents that occur in hospitals but also those that occur outside and bring victims to hospitals.

“In 2022, there were 2,105,245 nonfatal and 73,989 fatal violence-related injuries that occurred in the U.S.,” the AHA wrote. “Violence also occurs in hospitals, where health care workers experience significant rates of violence from patients and visitors. This leads to staff turnover, absenteeism, loss of productivity, high costs in disability and indemnity, and an increased risk of depression, post-traumatic stress disorder and suicide.”

For this survey, which leveraged 2023 data from hospitals and health systems nationwide, the AHA sought to measure the financial burden that everything from training to hiring security to the indirect cost of caring for victims has on the healthcare system.

What the organization found is that training, security systems and modifying facilities to mitigate violence was actually the lowest portion of the total cost, coming in at $3.6 billion. Providing care for the victims of both fatal and nonfatal attacks—including shootings, stabbings, sexual assaults, etc.—costs hospitals upwards of $13 billion, the AHA found.

Further, when number-crunchers factor in overtime, employee absenteeism and turnover as a result of violence incidents inside and outside the workplace, another $541.3 million gets added. 

When all contributing costs are identified and accounted for, violence incidents and their aftermath cost hospitals and health systems about $14.7 billion each and every year.

The AHA said this includes the costs of caring for uninsured and underinsured patients who may not have treatment covered. It also includes damage to infrastructure in and around hospitals, which costs money to repair.

“We estimated that each year, metropolitan hospitals are responsible for replacement and repair of infrastructure and equipment equating to 1% of their reported capital expenses. We estimated that [metropolitan] and rural hospitals are responsible for 0.5% and 0.25%, respectively, of their capital expenses for repairs and replacements resulting from violence within the facility and surrounding community,” it wrote.