Hospital costs for those with gun injuries approach $100,000 per patient
By Emma Court
The analysis likely underestimates the costs because it couldn't follow patients over time, its authors concede
Gun-related injuries result in nearly $3 billion in hospital costs each year in the U.S., according to a new study published in the peer-reviewed journal Health Affairs.
Patients were charged about $5,000 on average for emergency-department services and nearly $96,000 on average for inpatient services, according to the study (http://content.healthaffairs.org/content/36/10/1729.full#xref-ref-16-1), which focused on patients who were alive when they arrived to the emergency room.
The study was released in the wake of a gun massacre at an outdoor country-music concert in Las Vegas, one of the deadliest mass shootings in U.S. history. (http://www.marketwatch.com/story/these-are-the-10-deadliest-mass-shootings-in-us-history-2017-10-02)
The analysis likely underestimates the cost of these injuries, its authors said, because it did not attempt to follow patients over time and thus couldn't track factors like readmissions, rehabilitation and lost income.
"Although firearm-related injuries are a major public-health concern (http://www.marketwatch.com/story/these-are-the-10-deadliest-mass-shootings-in-us-history-2017-10-02), with significant financial consequences, research in this area has been limited as a result of a lack of funding," the authors said, noting that while gun violence accounts for around as many deaths as sepsis infection, funding for gun-violence research equates to just 0.7% of the funding for sepsis research. (The 1996 Dickey Amendment, named for the late Arkansas Republican congressman Jay Dickey (http://www.npr.org/2017/04/25/525604434/jay-dickey-arkansas-congressman-who-blocked-gun-research-dies-at-77), bars the Centers for Disease Control and Prevention from funding gun research.)
That research is especially necessary, the authors said, because "only through the adoption of an evidence-based public-health approach can the resulting substantial medical and financial burden be reduced."
Read more: This is how much gun injuries cost the U.S. every year (http://www.marketwatch.com/story/this-is-how-much-gun-injuries-cost-the-us-every-year-2017-03-22)
That burden may be highest for uninsured individuals, since the cost of care tends to be more expensive for that population, the study said. Uninsured patients -- along with individuals who self-pay -- either "bear the entire financial burden of their injuries in the form of out-of-pocket spending, or these costs remain unrecovered," the authors said.
Gun injuries were most common among individuals between the ages of 15 and 29, and especially so among men in that age range, at a rate that was ninefold higher than for young women, the study found.
In general, men made up a "disproportionately higher" share of emergency-room visits for gun injuries, compared with women, according to the study.
Between 2006 and 2014, the time period studied, gun injuries decreased between 2006 and 2013 by 23% but increased by nearly 24% in 2014. Over time, a larger share of injured patients had a mental-health diagnosis, amounting to a nearly 42% increase between 2006-08 and 2012-14.
See: These are the 10 deadliest mass shootings in U.S. history (http://www.marketwatch.com/story/these-are-the-10-deadliest-mass-shootings-in-us-history-2017-10-02)
Most patients the study looked at were injured in an assault, nearly 50%, or unintentionally, about 35%. Smaller shares of patients were injured attempting suicide (5%) or as a result of police or other law enforcement involvement (2%).
The most common types of guns involved were handguns (27%), followed by shotguns (6%) and hunting rifles (2%), though in the majority of cases the firearm was unspecified (65%).
Of injured patients, nearly half were discharged from the hospital, 8% went to other facilities for more care, 37% were admitted to the hospital and 5% died in the emergency department. Total, 8% of patients died either in the emergency department or during their time in the hospital.
See: Gun-maker stocks rally after mass shooting in Las Vegas (http://www.marketwatch.com/story/gun-maker-stocks-surge-after-mass-shooting-in-las-vegas-2017-10-02)
The Health Affairs study was written by Faiz Gani, a postdoctoral research fellow at Johns Hopkins University School of Medicine; Dr. Joseph Sakran, assistant professor at Johns Hopkins; and Joseph Canner, acting co-director of the Johns Hopkins Surgery Center for Outcomes Research.
Sakran, who was shot in the throat as a high-school student in Virginia, was motivated by the experience to become a doctor and "give others that second chance I've been given," he told the Baltimore Sun last year (http://www.baltimoresun.com/news/maryland/baltimore-city/bs-md-ci-shoot-to-kill-surgeons-20161127-story.html).
Study data came from the Nationwide Emergency Department Sample (https://www.hcup-us.ahrq.gov/nedsoverview.jsp), the largest database of hospital emergency-department visits that includes all health-insurance payers, between 2006 and 2015. Prices were adjusted for inflation and presented in 2017 dollars, according to the study's methodology.
Because of the data used, the analysis did not cover patients who died before reaching a hospital or didn't go to a hospital after a gun injury.
The study also couldn't include patients' races in its analysis, since NEDS doesn't track race, and could only report emergency-department charges, which might not represent what treating gun injuries actually cost the hospitals, the authors acknowledged.
-Emma Court; 415-439-6400; AskNewswires@dowjones.com
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