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Comparison of cost and resource utilization between firearm injuries and motor vehicle collisions at pediatric
Kiesha Fraser Doh1,2, Erica Sheline3, Martha Wetzel4
1Departments of Pediatrics and Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Insights
Firearm injuries are a leading cause of death for US children, costing nearly five times more in hospital care than motor vehicle collisions. This highlights the need for increased focus and funding on firearm injury prevention strategies.
Area of Science:
- Pediatric Health
- Injury Prevention
- Health Economics
Background:
- Firearm injuries are a leading cause of death for children in the US, rivaling motor vehicle collisions.
- Understanding the economic and resource implications of firearm injuries is critical for public health.
- This study compares healthcare costs and resource use for pediatric firearm injuries versus motor vehicle collisions.
Purpose of the Study:
- To compare hospital costs and resource utilization between children with firearm injuries and those with motor vehicle collisions.
- To identify key differences in healthcare resource allocation for these two injury types.
- To inform policy and funding decisions for injury prevention.
Main Methods:
- Retrospective, cross-sectional study of pediatric patients (0-19 years) from January 1, 2013, to December 31, 2017.
- Data from 35 freestanding children's hospitals in the Pediatric Health Information System.
- Analysis using generalized linear mixed models to compare costs and resource utilization, adjusting for patient and hospital factors.
Main Results:
- Firearm-injured youth had significantly higher hospitalization rates (49% vs. 14%) and intensive care unit admissions compared to motor vehicle collision-injured youth.
- Patients with firearm injuries experienced longer hospital stays and more frequent emergency department visits and readmissions.
- Mean per-patient hospital costs were nearly fivefold higher for firearm-injured children compared to those with motor vehicle collisions.
Conclusions:
- Hospital costs and resource utilization are substantially higher for pediatric firearm injuries than for motor vehicle collisions.
- The high medical resource burden associated with firearm injuries underscores the need for comparable national attention and funding for prevention.
- Investing in firearm injury prevention is crucial to mitigate significant healthcare costs and improve child safety.
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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