Cost of hospitalization for firearm injuries by firearm type, intent, and payer in the United States

Abstract

BackgroundFirearm injuries disproportionately affect young, male, non-White populations, causing substantial individual and societal burden. Annual costs for hospitalized firearm injuries have not been widely described, as most previous cost studies have focused on lifetime costs. We examined a nationally-representative database of hospitalizations in the US to estimate per-hospital and overall hospital costs for firearm injuries by intent, type of weapon, and payer source.MethodsWe conducted a retrospective cohort study of all firearm injury hospitalizations in the National Inpatient Sample from 2003 through 2013. The National Inpatient Sample, maintained by the Healthcare Utilization Project, is a stratified and weighted national sample of more than 20% of all hospitals. All admissions for firearm injuries were identified through Ecodes, yielding a weighted total of 336,785 for the study period. Average annual per-patient and overall hospital costs were estimated using generalized linear modelling, controlling for patient and hospital variables. Costs by intent, firearm type, and payer sources were estimated.ResultsAnnually from 2003 through 2013, 30,617 hospital admissions were for firearm injuries, for an annual rate of 10.1 admissions per 100,000 US population. More than 80% of hospitalizations were among individuals aged 15–44, and rates were nine times higher for males than females and nearly ten times higher for the Black than the White population. More than 60% of admissions were for assaults, and 70% of the injuries that had a known firearm type were from handguns. The average annual admission cost was $622 million. The highest per-admission costs were for injuries from assault weapons ($32,237 per admission) and for legal intervention ($33,462 per admission), but the highest total costs were for unspecific firearm type ($373 million) and assaults ($389 million). A quarter of firearm injury hospitalizations were among the uninsured, yielding average annual total costs of $155 million.ConclusionHospitals can project that government insurance will be the highest source for firearm injury reimbursement, and depending on healthcare access laws, that many of their firearm injury admissions will not be covered by insurance.

Nonfatal Firearm Violence Trends on the Westside of Chicago Between 2005 and 2016

“…Hospitals are critical to the firearm violence narrative, as their EDs and inpatient units see the majority of firearm violence victims. Between 2003 and 2013, the annual rate of hospital admissions due to firearm injuries nationally was 30,617 [20]. More than 80% of these hospitalizations were among individuals aged 15–44 [20].…”

Gun Ownership and Life Satisfaction in the United States

“…The cumulative evidence clearly calls into question the role of guns in the lives of Americans (Dowd-Arrow, Hill, and Burdette, 2019;Hill et al, 2020aHill et al, , 2020b. Research plainly shows that guns have the capacity to undermine the health and safety of individuals, families, and the broader society (Fleegler et al, 2013;Fowler et al, 2015;Gani, Sakran, and Canner, 2017;Gramlich, 2019;Kellermann et al, 1993;Miller, Azrael, and Hemenway, 2002;Miller, Hemenway, and Azrael, 2007;Peek-Asa, Butcher, and Cavanaugh, 2017;Spitzer et al, 2017;Van Kesteren, 2014). While these costs can no longer be denied, the personal benefits of guns remain open to scientific scrutiny and public debate.…”

“…In fact, several studies show that owning a gun or having a gun in the home increases the risk of gun-related violence and homicide for men, women, and children (Gramlich, 2019;Kellermann et al, 1993;Miller, Azrael, and Hemenway, 2002;Miller, Hemenway, and Azrael, 2007;Van Kesteren, 2014). It is estimated that national annual health-care costs associated with firearm-related injuries can reach into the billions (Gani, Sakran, and Canner, 2017;Peek-Asa, Butcher, and Cavanaugh, 2017;Spitzer et al, 2017).…”

Firearm injuries in rural Saudi Arabia: incidence, patterns, management, and cost

“…They concluded that many, almost certainly, face a long, painful recovery reflected in high medical bills (DiGravio 2018). This study was supported by multiple centers, such as Stanford University School of Medicine and Iowa University School of Medicine, which estimated the initial hospitalization cost of firearm injuries ranging from US$622 million to US$735 million per year (Peek-Asa et al 2017).…”

“…According to the Health Care Utilization Project (HCUP) USA, firearm injuries posed the largest overall hospitalization cost burden with total annual hospitalization costs nearly US$183 million (Peek-Asa et al 2017). There were no previous reports on the hospitalization cost as a result of firearm-related injuries from Saudi Arabia, which cause significant burden to the local economy, the country health system, and the society reported from other developed countries.…”