Violence, usually related to gun or firearm use, is a frequent cause of traumatic injury with significant mortality and morbidity. Although there are numerous fatalities due to gun violence, the major of those who have gun or violence-related injury survive their initial but require extensive medical care. Very little is known about survivors of violence and their use of healthcare, especially in the outpatient setting, despite the long-term effects of violence-related injury. Based on previous work, we believe that there are disparities in access and utilization of healthcare services among patients with violence related injury compared those with other traumatic injuries. We propose to evaluate the relationships between access to care, medical outcomes and complications, and regional characteristics of patients in this population. We will identify patients with acute traumatic injury from the Harborview Trauma Registry and evaluate their (1) access to medical care and rehabilitative services during the first year after injury and (2) medical complications and repeat hospitalization using information from medical records review and the Washington State All Payer Database. The results of this study will help researchers, hospitals, and patients understand healthcare utilization patterns and predictors and determine the relationship between appropriate outpatient standard of care after traumatic injury and risk for subsequent hospitalization. This research will help Washington State providers understand the healthcare utilization of high-risk groups and determine options to optimized care and outcomes.