A Hospital Tells Police Where Fights Happen, And Crime Drops
npr.org
npr.org
They didn't need to indiscriminately take patient records out of their backend systems or monitor the hospitals networks and reverse engineer http and packets. They didn't need to target individuals who are repeat offenders or violate any privacy consideratio.
I'd say 150 years ago the nurse was telling the sheriff the boys keep getting too roudy at the saloon, too.
When the systems were first installed, they provided a ton of good information and the crime rate dropped. Homicides were reduced, less gang activity, etc.
Well after a couple of years of reducing crime by double digit percentages, suddenly that became the standard. So there were perverse incentives to do things like classify crimes as lesser offenses. If you can talk people into only complaining about assault, your rape crime count can go down.
At the same time, if there isn't enough crime, you don't need as many cops. So there are also incentives to write more tickets and criminalize more things. Since it's now a crime to walk with your shoes untied, the police can say "Look, this year arrests are up 10%! We're really doing a good job!" or "New kinds of crime are taking over, we need some people for a task force.".
Once upon a time ago it was intensely debated whether the effect of disclosures of drug or weapon possession to prison administration would negatively affect prisoner cooperation and the quality of healthcare. Inmates were known for storing weapons or drugs in their rectum, physicians worried that if an X-Ray were to reveal such objects and if they were required to disclose them that inmates would stop accepting X-Rays and general health would decline.
The general consensus of studies that examined this issue showed that this did not in fact happen[1]. It was found that as long as only things that risk the health of the general population (i.e. drugs don't need to be reported but weapons do) were reported there were no adverse effects.
Extrapolating to the general population, one could conclude that this hospital's practices wouldn't discourage people from going to the hospital. Criminals that would be discouraged by this policy would likely not be going to the ER prior to its implementation (similar to how inmates with knives in their rectum still won't go to a physician despite HIPAA protection) because they're afraid of being caught doing something illegal. You can't really do anything for this subset of the population however you can help the majority by sharing this information with the police while causing minimal (or no) harm to any individual patient.
[1] I read this in "Doing Right" by Hebert, PC. In the book they cited a study but I no longer have it, if someone really wants this reference I can go hunt for it. I wouldn't recommend buying this book as it's ridiculously overpriced.
We all know a lot of crimes go unrelated but I never thought certain classes of crimes would be so significantly under-represented.
I'm guessing the type of guys getting into fights in Cardiff bars are going to stop telling the hospital staff when they realize it could lead to their favorite bar getting targeted by the police or even shut down.
The main issue that this programme tackles (apparently quite effectively) is that the police often aren't even aware that an assault has taken place (and so can't target the area it happened in).
Certainly in some gang-related crimes the victims refuse to talk to anyone, but this is a very different situation. How is reducing violent crime by somewhere between 30 and 40% a bad idea?
I remember being hit by a car on my bike (a famously under-reported incident), but both myself and my girlfriend physically/emotionally were in rough shape all day. We forgot to report it, then it ended up slipping out of our minds.
This is a challenging problem to solve with technology, similar to getting patients to take their daily medication on time.
AFAIK you can file a police report at any time. Whether your report leads to any results is probably negatively correlated with how long you wait to file it, but you can't be sure it won't until you actually report it.
However, many crimes (especially more minor ones) have a statute of limitations, where the crime can't be prosecuted after a certain amount of time.
And older investigations are harder -- a witness in a house adjacent to the crime scene may have remembered hearing a crunch followed by a car speeding away at the time of the accident if interviewed the following day or week, but may have utterly forgotten, or moved away and be impossible to locate, or have become unable to testify due to developing mental incapacity or becoming deceased, if the day in question was months, years, or decades ago. Likewise, the next day there might be tire marks, bike parts, or other physical evidence at the crime scene, but after months or years it will have deteriorated or totally disappeared.
Also police surely know that older investigations are harder, so in addition to the problems with the evidence itself, having an older case you might not be assigned as many police resources because they know there's a lower probability of success, and it's their duty to taxpayers to use their limited number of detectives, etc. on the cases they have the best likelihood of solving, so those taxpayer dollars are used most efficiently.
But this doesn't mean you shouldn't report it. You don't know exactly how your crime will be classified (assault? traffic offense? attempted homicide?), so you don't know what the statute of limitations actually is.
It might be that your report provides the missing piece of a puzzle -- there might be a cold case file in the police station saying, "A local mechanic noticed a car brought in for repairs had bike parts embedded in the grille and blood on the tires, the license and owner information was entered in the case file, and we're pretty sure we know who was driving. But no hit-and-runs had been reported recently, we know a jury won't convict without an identifiable victim, and the investigation was closed due to reaching a dead end."
They wont force you to report, but they will definitely try to convince you to tell them where you got the wound from.
let me explain - in India, it is mandatory for hospitals to reports all "unnatural" incidents to the police - which means crime, traffic accidents, etc. Now because of the already understaffed police and/or corruption in the force itself, what happens is that the hospital tends to withold critical care until the police report is completed. In recent times, this has snowballed into a huge controversy and caused some other laws being passed to ensure care first.
Now here's the issue - this is still a gray area. Let's say you are a newly minted doctor working in the hospital and a patient comes in with several injuries and who tells you that there is a gang incident in a pub and likely many people are injured. What is the mandated process - do you have to make a police report first, or do you provide medical care first ? Doing either can result in the doctor being blamed for something or other.
Or is there a dedicated "liason" whose job is to do the reporting and leave the care to the doctors. Which would mean staffing for a role like that would be difficult in a non-publicly funded medical institution.
When two gangs fight and people get injured but don't want the police to know about the location of the fight (an illegal clubhouse?), wounds are either ignored or stitched up by backalley doctors.
Gangs tend to use social networks to organise fights. People in the UK tend to get wounds treated.
(http://www.scotland.gov.uk/Publications/2011/07/05130225/3)
> 89. Another innovative idea being taken forward is the sharing of 'anonymised' information collected at Accident and Emergency (A & E) departments in hospitals concerning the incidence of violence and use of weapons at particular geographical 'hotspots' so that police can track violence trends and take preventative measures. Many victims of violence do not report the crime to the police but do attend at A & E with their injuries. The National Violence Surveillance Network established by the Cardiff University Violence Research Group in England and Wales found that such measures led to decreased numbers of wounded victims attending A & E as a result of violence and a decrease in serious assaults reported to the police. A pilot study is underway in Lanarkshire hospitals along the same lines.
Here's what the Royal College of Nursing says about reporting crime: (http://www.rcn.org.uk/__data/assets/pdf_file/0009/287793/03....). This mentions the Cardiff Model.
2006: (http://www.independent.co.uk/news/uk/crime/the-streets-of-sc...)
> But doctors have admitted that the vast majority of stab wounds treated in the city's hospitals go unreported to the authorities. The scale of the violence is feared to be much greater than officially acknowledged.
[...]
> Last September the United Nation's crime research institute said Scotland was the most violent country in the developed world. Scots were nearly three-times more likely to be the victims of violent assaults than people living in the United States. More than 50 per cent of knives found by the police in Scotland are seized in Glasgow. Stabbings account for half of all murders.
2011: (http://www.heraldscotland.com/news/home-news/shocking-rise-i...)
> According to the newly-published annual Global Study on Homicide, the homicide rate in Glasgow stood at 3.3 per 100,000, compared to 1.6 in the English capital.
> The report also shows Scotland’s homicide rate remains higher than in many other European countries, including England and Wales, Poland, Hungary, Croatia, Spain, Portugal and Italy. Figures for France were not available.
2013: (http://www.scotsman.com/news/glasgow-knife-crime-falls-by-a-...)
> There were 903 assaults involving blades in the period 2012-2013, compared with 1,439 the year before, a fall of 37 per cent. The rate is down 57 per cent since 2006-2007, when 2,138 knife attacks were recorded in the city.
> Officers have attributed the fall in knife crime to an increase in stop and search procedures across Glasgow. In November, 2007 the number of such searches carried out in the city was 4,356. Five years on, this figure has risen to 26,669.
Strange, I thought they were obligated to call the cops when someone with obvious such injuries went to the hospital. You know, if you have a black eye, broken nose and a stab wound, "I fell from the stairs" probably not gonna do it.
That said, due to the litigious nature of the US some patients are still likely to sue and/or generate bad press. While it's unlikely that a court would find the doctor/hospital guilty of any HIPAA violations it's a giant headache the hospital and their lawyers don't want to deal with.
Yes doctor, you just hit the "save to SQL database" right here on your plastic clipboard...
When you put hundreds of thousands of man-hours into digitizing an archive, there's essentially a cost/value-add. If there wasn't a value-add, why would you want this hypothetical database anyway? The crime information is public, why don't you just go compile it yourself!
The whole thing of hospitals reporting violence police sounds is a gangster movie cliche: someone gets shot and his friends rush him to a disgraced dentist who removes the bullet on the kitchen table with a splash of whiskey and a dirty switchblade.