Thursday, February 27, 2020
Home News Healthcare Administrator News The Rising Toll of Firearm Injuries in the U.S.

The Rising Toll of Firearm Injuries in the U.S.

New research sheds light on the toll gun injuries take on patients, healthcare providers, and the American healthcare system. 

Although a preventable public health issue, the number of firearm-related injuries in the United States increases every year. In 2015, there were over 36,000 deaths and 85,000 nonfatal injuries caused by firearms. The PLoS One Journal recently published a study that quantified the cost of firearm-related injuries and assessed the risk of hospital readmissions from 2010 to 2015. 

The five-year study determined that the average cost of hospitalization for firearm injuries was $32,700 per patient. For initial inpatient hospitalizations and readmissions, the average cost for all patients was $911 million. Medicare and Medicaid government programs shouldered 45% of the expense, while 20% fell upon the uninsured. 

Readmissions totaled 9.5%, or $86 million, of the overall $911 million.  On initial admission, the payer status for readmitted patients were as follows: Medicare (10.0%), Medicaid (35.9%), private insurance (20.2%), self-pay (20.2%) and other (15.2%), which included patients not charged and those with alternative forms of insurance. 

Medicaid patients had a greater readmission risk of 17.6%, while self-pay patients had the lowest readmission risk of 12.1%. It is possible that economic and social factors decreased the likelihood of self-pay patients receiving follow-up care. Self-pay patients are often faced with full charges of their inpatient hospital stays. Since there is no third-party negotiator, it could be difficult to afford a readmission. 

Additionally, 84% of Medicaid patients live in zip codes that fall below the 50th income quartile. The average, unadjusted charge of a self-pay patient’s readmission was $49,087, a significant financial expense that warrants further investigation into the risks of readmission.

Another finding was that one in seven, or 15.6%, of patients discharged from the hospital were readmitted within six months over the five year span. Of those readmissions, over 50% occurred within 30 days. The readmission risk was greater for patients who:

  • Were older
  • Had higher injury severity scores
  • Had longer lengths of stay
  • Required an operation 
  • Had a non-routine discharge at initial admission
  • Had ongoing, chronic medical and social problems, classified as “chronic trauma syndrome”

If your patient with a firearm injury meets at least some of these criteria, monitor the patient closely to prevent readmission and to alleviate a substantial burden on both patients and the US healthcare system.

There were some drawbacks to this study, such as the exclusion of firearm-related injuries for patients treated and released from the emergency room. Nevertheless, the findings are reliable and support public policy reform to reduce devastating and expensive firearm-related injuries.

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