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Citation
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Quiroz HJ, Casey LC, Parreco JP, Willobee BA, Rattan R, Lasko DS, Perez EA, Sola JE, Thorson CM. J. Pediatr. Surg. 2020; ePub(ePub): ePub. |
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Affiliation
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Division of Pediatric Surgery, Dewitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL. Electronic address: cthorson@med.miami.edu. |
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Abstract
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PURPOSE: Pediatric firearm injury is a national crisis that inflicts significant trauma. No studies have captured risk factors for readmissions after firearm injury, including cost analysis.
METHODS: Nationwide Readmissions Database (2010-2014) was queried for patients <18 years admitted after acute firearm injury. Outcomes included mortality, length of stay, hospital costs, and readmission rates (30-day and 1-year). Multivariable logistic regression identified risk factors, significance set at p < 0.05.
RESULTS: There were 13,596 children admitted for firearm injury. Mortality rate was 6% (n = 797). Self-inflicted injury was the most lethal (37%, n = 218) followed by unintentional (5%, n = 186), and assault (4%, n = 340), all p < 0.01. Readmission rates at 30 days and 1-year were 6% (12% to different hospital) and 12% (19% to different hospital), respectively. Medicaid patients were more frequently readmitted to the index hospital, whereas self-pay and/or high income were readmitted to a different hospital. The total hospitalizations cost was over $382 million, with $5.4 million due to readmission to a different hospital.
CONCLUSION: While guns cause significant morbidity, disability, and premature mortality in children, they also have a substantial economic impact. This study quantifies the previously unreported national burden of readmission costs and discontinuity of care for this preventable public health crisis. TYPE OF STUDY: Retrospective Comparative Study. LEVEL OF EVIDENCE: Level III.
Copyright © 2020 Elsevier Inc. All rights reserved.
Language: en |