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Hospitalizations for firearm-related injuries. A population-based study of 9562 patients
1School of Medicine, University of California, Davis, USA.
Insights
Firearm injuries led to 9,562 hospitalizations in California in 1991, disproportionately affecting young Black males and costing millions. This highlights the need for improved firearm injury surveillance.
Area of Science:
- Public Health
- Trauma Surgery
- Health Economics
Background:
- Firearm-related injuries represent a significant public health concern.
- Understanding the epidemiology and economic impact of these injuries is crucial for targeted interventions.
Purpose of the Study:
- To determine the incidence, nature, demographics, severity, and hospital charges associated with inpatient treatment of firearm-related injuries in California.
Main Methods:
- A retrospective, population-based study using 1991 California Hospital Discharge Abstract Data.
- Analysis included 9,562 patients discharged with firearm-related injuries, examining per capita rates by age, race, and sex.
Main Results:
- In 1991, 9,562 firearm injuries resulted in hospitalization in California (32 per 100,000 population).
- Young males (15-24 years) accounted for 72% of hospitalizations, with Black males aged 15-24 having the highest discharge rate (439 per 100,000).
- Hospital charges exceeded $164 million, with 56% of patients covered by publicly financed insurance.
Conclusions:
- Firearm violence is a major cause of hospitalization for young urban Black males, imposing substantial costs on public healthcare.
- The burden of these injuries is disproportionately concentrated in a few hospitals.
- Hospital discharge data are valuable for surveillance, but enhanced local, state, and national data collection is needed.
Objective:
To determine the incidence, nature, demographics, severity, and hospital charges associated with inpatient treatment of firearm-related injuries.
Design:
A retrospective, 1-year, population-based study of firearm-related hospitalizations based on the 1991 California Hospital Discharge Abstract Data Tapes.
Setting:
California acute care hospitals that reported firearm-related discharges.
Patients:
A total of 9562 patients discharged with firearm-related injuries.
Main Outcome Measures:
Per capita hospital discharge rates, according to age, race, and sex.
Results:
A total of 9562 firearm-injured persons were discharged from California hospitals in 1991, representing a rate of 32 discharges per 100 000 population. Males aged 15 to 24 years accounted for 72% of the hospitalizations. For all causes of firearm-related injury, the highest age- and race-specific discharge rate was 439 per 100,000 for black persons aged 15 to 24 years. The highest county discharge rate was 55 per 100,000 for Los Angeles County. Statewide, there were 1.8 hospital discharges per firearm-related fatality (both in the hospital and in the community). Assaults accounted for 74% of cases. Among black males aged 15 to 24 years, assaults accounted for 598 discharges per 100 000 population. Hospital charges for 9193 patients exceeded $164 million; mean and median charges per patient discharged were $17,888 and $8535, respectively. Publicly financed health insurance programs sponsored 56% of patients; 25% had private insurance, and 19% were uninsured. Fifty-three percent of the discharges occurred at 13 of the 371 hospitals that discharged patients with firearm-related injuries.
Conclusions:
Firearm-related violence is a major cause of hospitalization of young urban black males and represents a significant cost to publicly financed health care. The impact on individual hospitals is highly disproportionate. While hospital discharge data can be used for population-based surveillance of firearm-related trauma, there is need for improvement in local, state, and national surveillance of these injuries.