Human and economic costs of pediatric firearm injury

Quiroz, Hallie J.; Casey, Liann C.; Parreco, Joshua; Willobee, Brent A.; Rattan, Rishi; Lasko, David; Pérez, Eduardo A.; Sola, Juan E.; Thorson, Chad M.

doi:10.1016/j.jpedsurg.2020.01.045

Cited by 22 publications

(17 citation statements)

References 27 publications

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“…Previous studies confirm a high readmission rate at 90 days 13 and 6 months for firearms injuries in both adults and children 14 . Using the nationwide readmission database evaluating only pediatric firearm injuries, a readmission rate of 6% at 30 days and 12% at 1 year was reported 15 . These rates specifically examined hospitalized youths who were discharged from the hospital and subsequently readmitted, while our study also included youths who presented to the ED with a firearm injury or MVC and were initially discharged but subsequently returned and were admitted.…”

Section: Discussionmentioning

confidence: 76%

Comparison of cost and resource utilization between firearm injuries and motor vehicle collisions at pediatric hospitals

Doh

Sheline

Wetzel

et al. 2021

Academic Emergency Medicine

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Background/Objectives Firearm injuries are converging with motor vehicle collisions (MVC) as the number one cause of death for children in the United States. Thus we examine differences in hospital cost and hospital resource utilization between motor vehicle and firearm injury. Methods This retrospective, cross‐sectional study compares hospital costs and resource utilization of motor vehicle and firearm‐injured children aged 0 to 19 years of age over a 5‐year time frame (January 1, 2013–December 31, 2017) in 35 freestanding children's hospitals that submitted data to the Pediatric Health Information System. The primary outcome was hospital‐adjusted comparative cost per patient presentation. Generalized linear mixed models were used to quantify the relationship between the type of injury and each outcome, adjusting for patient characteristics and hospital. Results There were 89,133 emergency department (ED) visits attributed to MVCs and 3,235 for firearm injury. Of the youths who presented for firearm injury, 49% were hospitalized versus 14% of youths presenting with MVC (adjusted odds ratio [aOR] = 6.6, 95% confidence interval [CI] = 6.1 to 7.2). Youths with firearm injury were more likely to be admitted to an intensive care unit (aOR = 6.7, 95% CI = 5.9 to 7.7) and had longer lengths of stays (aOR = 2.2, 95% CI = 1.9 to 2.6) compared to their MVC counterparts. Children admitted for firearm injury had more imaging and ED return visits, along with subsequent inpatient admission within 3 days (aOR = 3.4, 95% CI = 2.1 to 5.5) and 1 year (aOR = 2.5, 95% CI = 2.1 to 2.9). The mean relative per‐patient costs were nearly fivefold higher for the firearm‐injured group. Conclusions Hospital costs and markers of resource utilization were higher for youths with firearm injury compared to MVC. High medical resource utilization is one of several important reasons to advocate for a comparable national focus and funding on firearm‐related injury prevention.

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Section: Discussionmentioning

confidence: 76%

Comparison of cost and resource utilization between firearm injuries and motor vehicle collisions at pediatric hospitals

Doh

Sheline

Wetzel

et al. 2021

Academic Emergency Medicine

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“…Regarding the economic burden, most literature has generally estimated costs of initial admissions or readmissions. Using 2010–2014 data from the Nationwide Readmissions Database, one study estimated a median cost of $12,619 for the initial injury-related hospitalization, while the median cost of the first readmission within 30 days and 1 year post-discharge was $7804 and $8451, respectively [ 8 ]. Another study using the Nationwide Emergency Department Sample 2006–2014 found that median ED visit and inpatient charges (2018 USD) were $2445 (IQR: $1318–$5191) and $44,966 (IQR: $21,156–$91,771), respectively [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…Average annual costs for the initial admission alone have been reported to be around $622-$735 million (2013 USD) [6,7]. However, little is known about the healthcare and economic burdens of non-fatal powdered and non-powdered (air gun) firearm injuries for children and youth beyond the initial admission, which are likely to occur at least 1-year post-injury, or at a population-based level, as many studies have been limited to single-center studies [8][9][10]. Moreover, no work has estimated costs by weapon type and intent.…”

Section: Introductionmentioning

confidence: 99%

Healthcare utilization and costs following non-fatal powdered and non-powdered firearm injuries for children and youth

et al. 2022

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Little is known about the healthcare and economic burdens of non-fatal firearm injuries for children/youth beyond the initial admission. This study sought to estimate healthcare utilization and total direct healthcare costs of non-fatal powdered and non-powdered (air gun) firearm injuries 1-year post-injury. Using administrative data from 2003 to 2018 on all children/youth 0–24 years old in Ontario, Canada, a matched 1:2 cohort study was conducted to compare children/youth who experienced powdered and non-powdered firearm injuries with those who did not. Mean and median number of healthcare encounters and costs, and respective 95% confidence intervals (CIs) and interquartile ranges (IQRs), were estimated for both weapon type groups and controls and by intent. Children/youth who experienced a powdered and non-powdered firearm injury had a higher number of healthcare encounters and costs per year than those who did not. Mean 1-year costs for those with powdered and non-powdered firearm injuries were $8825 ($8007–$9643) and $2349 ($2118–$2578), respectively, versus $812 ($567–$1058) and $753 ($594–$911), respectively, for those without. Mean 1-year costs were highest for handgun injuries ($12,875 [95% CI $9941–$15,808]), and for intentional assault-related ($13,498 [$11,843–$15,153]; $3287 [$2213–$4362]), and intentional self-injuries ($14,773 [$6893–$22,652]; $6005 [$2193–$9817]) for both powdered and non-powdered firearm injuries, respectively. Conclusion: Firearm injuries have substantial healthcare and economic burdens beyond the initial injury-related admission; this should be accounted for when examining the overall impact of firearm injuries. What is Known:• Child/youth firearm injuries have significant health and economic burdens.• However, existing work has mainly examined healthcare utilization and costs of initial admissions and/or have been limited to single-center studies and no studies have provide cost estimates by weapon type and intent. What is New:• Children/youth who suffered powdered firearm injuries had higher mean healthcare utilization and costs than those with non-powdered firearm injuries as well as comparable healthy children/youth.• Mean 1-year costs were highest for handgun injuries ($12,875), and for intentional assault-related ($13,498; $3287), and intentional self-injuries ($14,773; $6005) for powdered and non-powdered firearm injuries, respectively.

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“…2 The societal cost of firearm injury and death is substantial, estimated at $400 million annually for acute medical treatment before including long-term medical and disability care costs, lost work and productivity, and criminal justice proceeding costs. 3 Scientific advances in firearm injury prevention have lagged substantially behind those for other injuries (eg, motor vehicle crashes) and medical diseases (eg, HIV/AIDS, cancer) of similar size and scope due to the lack of federal research funding during the past 30 years. 4 When compared with the incidence and severity of disease and federal funding response for other leading causes of death (eg, motor vehicle crash, VIEWPOINT…”

mentioning

confidence: 99%

“…Among children and teenagers, aged 1 through 19 years, firearms are now the leading cause of death, surpassing motor vehicle crash injury in 2020 . The societal cost of firearm injury and death is substantial, estimated at $400 million annually for acute medical treatment before including long-term medical and disability care costs, lost work and productivity, and criminal justice proceeding costs …”

mentioning

confidence: 99%

The Role of Academic Medical Centers in the Prevention of Violence and Firearm-Related Morbidity and Mortality

Cunningham

Lee

Carter

2022

JAMA

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Human and economic costs of pediatric firearm injury

Cited by 22 publications

References 27 publications

Comparison of cost and resource utilization between firearm injuries and motor vehicle collisions at pediatric hospitals

Comparison of cost and resource utilization between firearm injuries and motor vehicle collisions at pediatric hospitals

Healthcare utilization and costs following non-fatal powdered and non-powdered firearm injuries for children and youth

The Role of Academic Medical Centers in the Prevention of Violence and Firearm-Related Morbidity and Mortality

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