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

Kiesha Fraser Doh · Erica K. Sheline · Martha W. Wetzel · Harold K. Simon · Claudia R. Morris

14 citations0/0 files storedAcademic Emergency Medicine

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Gun Ownership and Violence Research Trauma and Emergency Care Studies Injury Epidemiology and Prevention

Abstract

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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References

2015Violent Death Rates: The US Compared with Other High-income OECD Countries, 2010 2018Firearm Storage in Gun-Owning Households with Children: Results of a 2015 National Survey 2019Long-term Functional, Psychological, Emotional, and Social Outcomes in Survivors of Firearm Injuries 2019Surveillance for Violent Deaths — National Violent Death Reporting System, 32 States, 2016 2017Funding and Publication of Research on Gun Violence and Other Leading Causes of Death 2018Effects of Risk-Based Firearm Seizure Laws in Connecticut and Indiana on Suicide Rates, 1981–2015 2014Hospitalizations Due to Firearm Injuries in Children and Adolescents 2004Outcomes in Children and Young Adults Who Are Hospitalized for Firearms-Related Injuries

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2023The Medical Costs of Firearm Injuries in the United States: A Systematic Review

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