Developing an Economic Model for Optimal Penalties in Healthcare Workplace Violence

General 31 may 2023  - NCBI

Healthcare workplace violence is a significant concern that poses threats to the well-being of healthcare workers and the overall functioning of healthcare organizations. In this article, Sun, Lin, and Wang (2019) present an economic model that focuses on generating a direct incentive system using optimal penalties to deter external perpetrators of violence in healthcare settings. By considering the characteristics unique to healthcare workplaces, the researchers aim to highlight the importance of aligning legislative punishments with the specific attributes of these environments.

Distinguishing Healthcare Workplaces:
To establish the need for a differentiated approach to addressing healthcare workplace violence, the researchers utilize a 3-dimensional analytical method. The dimensions include externality, identifiability, and preventability, which help distinguish healthcare workplaces from ordinary workplaces. Firstly, healthcare workplaces are an integral part of the social emergency service system, and any violence occurring in these settings has significant negative externalities. Additionally, due to the compulsory contracting characteristics of healthcare organizations, external violence against healthcare workers often lacks identifiability and preventability.

Understanding the Cost Structure:
To comprehend the true impact of healthcare workplace violence, the researchers conduct a comprehensive cost structure analysis. In addition to considering the private costs borne by victims, they emphasize the social costs associated with healthcare workplace violence. These social costs include the public safety costs resulting from externalities, as well as two specific cost items related to the healthcare context: defensive medicine costs and specific factors costs. By considering the complete cost structure, the researchers aim to enable more efficient allocation of judicial resources and strike a balance between the costs and benefits of criminal acts against healthcare workers.

Optimal Penalty Model:
To determine the optimal penalties for healthcare workplace violence, the researchers construct a simple model that compares it to ordinary violent crime without externalities. Through comparative static analysis, they find that an upward tilting of the violence cost curve leads to a significant increase in the optimal penalty for different levels of violence. Furthermore, this adjustment lowers the threshold level of punishable violence, thereby offsetting the social costs associated with healthcare workplace violence. The magnitude of the public safety cost, which is directly linked to the importance of healthcare workplaces within the service network, influences the recommended penalty. Higher public safety costs necessitate greater penalties, emphasizing the protection of public interest associated with healthcare workers as individuals.

Establishing an Incentive System:
While the goal of an anti-violence policy is not to completely eliminate violence in healthcare workplaces, the researchers emphasize the importance of establishing an incentive system that directly targets perpetrators, effectively reducing the incidence of violence and its associated harm. By adopting an optimized penalty design, they aim to largely diminish defensive medicine costs, specific factors costs, and compensate for public safety costs. However, implementing such a system requires efforts to persuade legislators and the public to embrace this approach, challenging the cultural assumption that violence is an inherent part of healthcare workers' jobs.

Areas for Further Study:
While this article provides valuable insights, the researchers acknowledge that further research is needed to expand on their study. Firstly, the Economic Incentive Penalty (EIP) method developed in this study focuses on optimal penalties concerning workplace characteristics, levels of violence, and appropriate punishments, rather than differentiating between types of violence. Future studies should explore potential discrepancies in optimal penalties between physical violence and verbal violence. Secondly, cost analysis specifically pertaining to verbal violence requires separate investigations, and additional research is needed to estimate other associated costs. Case studies and empirical work can provide valuable evidence in this regard. Finally, further exploration of the justification of violence may reveal marginal effectiveness in preventing healthcare workplace violence from the perpetrators' perspective. Such considerations should be viewed as integral components of comprehensive solutions, including healthcare financing, training and education, regulation, and employer responsibilities.

In their article, Sun, Lin, and Wang (2019) present an economic model aimed at establishing an optimal penalty system for healthcare workplace violence. By recognizing the unique characteristics of healthcare workplaces, the researchers provide insights into the importance of aligning legislative punishments with the specific attributes of these environments. Their findings contribute to the ongoing efforts to create an incentive system that effectively deters violence in healthcare settings, ultimately benefiting healthcare workers and the overall healthcare system.

Sun, Z., Lin, S. X., & Wang, S. (2019). An Economic Model of Optimal Penalty for Health Care Workplace Violence. Inquiry, 56, 0046958019884190. doi: 10.1177/0046958019884190

General 31 may 2023  - NCBI
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