The Journal of Emergency Medicine
Volume 32, Issue 2 , Pages 141-147, February 2007

Criminal correlates of injury-related emergency department recidivism

  • Cynthia A. Claassen, PHD

      Affiliations

    • Mood Disorders Research Program and Clinic, Department of Psychiatry, University of Texas at Houston—Dallas Campus, Dallas, Texas
    • Corresponding Author InformationReprint Address: Cynthia A. Claassen, phd, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9119
    • ,
  • Gregory Luke Larkin, MD, MSPH, FACEP

      Affiliations

    • Department of Surgery, Emergency Medicine and Public Health, University of Texas at Houston—Dallas Campus, Dallas, Texas
    • Gregory Luke Larkin is currently affiliated with Yale University School of Medicine, Department of Surgery, New Haven, CT, USA.
    • ,
  • Gayle Hodges, MS

      Affiliations

    • Division of Clinical Psychology, University of Texas at Houston—Dallas Campus, Dallas, Texas
    • ,
  • Craig Field, PHD, MPH

      Affiliations

    • School of Public Health, University of Texas at Houston—Dallas Campus, Dallas, Texas

Received 31 January 2005; received in revised form 3 November 2005; accepted 22 May 2006.

Abstract 

To investigate criminal and high-risk lifestyle factors that predict emergency department (ED) recidivism, a longitudinal (8-year) cohort study of ED trauma patients was conducted. Study patients provided risk and lifestyle behavior information via semi-structured interview. ED revisit and re-injury rates for 1995–2003 were acquired through hospital record review. Lifetime criminal arrest data were obtained for each study subject via record linkage from PublicData.com, an internet-based service. The 8-year ED re-visit rate was 47% (75/161), but revisits were more often medical than injury-related (30% vs. 17%, respectively). Over half (58%) of all injured ED patients had a documented arrest history, and arrests were significantly more common in those who came back to the ED for repeat trauma vs. those who did not revisit the ED (70.4% vs. 55.9%, respectively; p < 0.05). In this sample, 21% (34/161) had been convicted of 97 property-related crimes, 26% (42/161) of 109 violence-related crimes, 23% (37/161) of 98 drug-related offenses, and 17.4% (28/161) of 89 other non-traffic-related crimes. ED recidivism for trauma care was associated with multiple substance abuse behaviors and drug-related arrests. Significant risk factors for ED recidivism seem to be high-risk substance-abuse-related behaviors and criminal activity, constituting important targets for effective ED-based intervention, referral, and follow-up.

Keywords: trauma, emergency services, recidivism, risk-taking

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PII: S0736-4679(06)00651-2

doi:10.1016/j.jemermed.2006.05.041

The Journal of Emergency Medicine
Volume 32, Issue 2 , Pages 141-147, February 2007

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