Texas emergency department visits for firearm injury: Trends & correlates 2016-2022

Understanding the nature and scope of fatal and nonfatal firearm injury in Texas is a necessary precursor to preventing firearm injuries statewide, however, Texas is frequently excluded from firearm injury research due to limitations in commonly used data sources.

Outcomes of interest were (1) emergency department (ED) utilization for firearm injuries and (2) associated charges in Texas 2016-2022. For both outcomes, this study examined longitudinal trends by patient demographics, payer, admission status, and county characteristics; and generated estimates for the association with county firearm ownership tercile. All Texas ED visits 2016-2022 (regardless of patient survival) with at least one salient ICD-10 external cause code (W32-W33, X72-X74, X93-X95, Y22-Y24, Y35) were compiled. Longitudinal associations were estimated using time series negative binomial regressions, with Poisson models for robustness.

Overall firearm injury ED utilization remained stable; however, injury severity may have increased, as the proportion of visits resulting in hospital admission rose and average total charges more than doubled in Texas 2016-2022. Each increase in county firearm ownership tercile was associated with more than a 10% increase in expected firearm injury ED visits.

Firearm injuries are a growing health and fiscal burden for Texas patients and taxpayers.