Retracted Nonfatal firearm injuries: Utilization and expenditures for children pre- and postinjury
Christian D Pulcini1, Monika K Goyal2, Matt Hall3
1Department of Surgery & Pediatrics, University of Vermont Medical Center, Children's Hospital, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA.
Insights
Nonfatal firearm injuries in children significantly increase healthcare encounters and costs. This study found a 40% rise in complex chronic conditions post-injury, highlighting the need for prevention to reduce child morbidity and healthcare expenses.
Area of Science:
- Pediatric Health
- Injury Prevention
- Health Economics
Background:
- Firearm injuries are a major cause of child morbidity and mortality.
- Data on the long-term healthcare utilization and costs of nonfatal firearm injuries in children is limited.
Purpose of the Study:
- To compare healthcare encounters and expenditures in children 1 year before and 1 year after a nonfatal firearm injury.
- To assess changes in complex chronic disease status following nonfatal firearm injury.
Main Methods:
- Retrospective cohort study using Medicaid MarketScan claims data (2010-2016).
- Included children aged 0-18 years with ICD-9/ICD-10 codes for firearm injury.
- Analyzed differences in healthcare encounters, expenditures, and complex chronic disease status pre- and post-injury.
Main Results:
- A total of 3,296 children were analyzed, with 47,660 encounters before and 61,660 after injury.
- Healthcare expenditures increased by $18.5 million overall ($5,612 per patient).
- A 40% increase in children qualifying for complex chronic condition status was observed post-injury.
Conclusions:
- Children experiencing nonfatal firearm injuries face increased healthcare utilization, chronic disease burden, and costs.
- Preventing firearm injuries in children can lead to substantial reductions in morbidity and healthcare spending.
Abstract:
Firearm injuries are one of the leading preventable causes of morbidity and mortality among children. Limited information exists about the impact of nonfatal firearm injuries on utilization and expenditures. Our objective was to compare health care encounters and expenditures 1 year before and 1 year following a nonfatal firearm injury. This was a retrospective cohort study of children 0 to 18 years with ICD-9/ICD-10 diagnosis codes for firearm injury in the emergency department or inpatient setting from 2010 to 2016 in the Medicaid MarketScan claims database. Outcomes included 1) difference in health care encounters for 1 year before and 1 year after injury, 2) difference in health care expenditures, and 3) difference in complex chronic disease status. Descriptive statistics characterized patient demographics and health care utilization. Health expenditures were evaluated with Wilcoxon signed-rank tests. Among 3,296 children, there were 47,660 health care encounters before the injury and 61,660 after. Concomitantly, there was an overall increase of $18.5 million in health expenditures ($5,612 per patient). There was a 40% increase in children qualifying for complex chronic condition status after firearm injury. Children who experience nonfatal firearm injury have increased number of health care encounters, chronic disease classification, and health care expenditures in the year following the injury. Prevention of firearm injuries in this vulnerable age group may result in considerable reductions in morbidity and health care costs.
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