Citation

Jacoby SF. JAMA Netw. Open 2022; 5(6): e2218502.

Copyright

(Copyright © 2022, American Medical Association)

DOI

10.1001/jamanetworkopen.2022.18502

PMID

35749120

Abstract

In their cross-sectional study, Barry and colleagues1 estimate the expense of emergency and inpatient medical care and the relative mortality associated with assault-related injuries in US hospitals. A primary objective is to specifically quantify the burden of interpersonal firearm assaults. The authors commendably combine several nationally representative data sources on emergency and inpatient care, health care outcomes, and health care charges and costs. As is possible, they use these data within the context of their limitations. The findings of this study support previous research that reports the costliness of assault injuries for US health care systems.2 Compared with more prevalent mechanisms of assault injuries, such as blunt force, firearm assault injuries are upheld as the costliest per injury. The high cost of firearm injuries results from the harm that bullet wounds catalyze in the body, the requirement for high-acuity clinical care, and the substantial physical, psychological, and social ramifications experienced by survivors.3

As recently as 2 decades ago, evidence of disparities in cost and mortality outcomes associated with assault-related traumatic injuries was scarce. This state of affairs has changed substantially and place-based, racialized, and economic disparities in assault injury risks and recovery outcomes are now well supported. There remains a crucial need for research to identify the underlying causes of these disparities and the ideal implementation of structural interventions, such as policies with broad public impact.4 Future studies on the economic and relative costs of assault-related hospitalizations will ideally progress from cross-sectional research to that which uncovers changes in disparities over time and the association of change with policy shifts or major clinical advancements.

Cross-sectional hospital cost and cost-recovery estimates have certain value as a lever to advocate for health system investment in preventive public health. Evidence that supports public health investment is important but can be limited in impact if not tied to specific policy and practice change recommendations. In discussing their findings, Barry and colleagues1 reinforce previous research that has shown the significant association between assault injuries and either a lack of insurance or use of Medicaid or Medicare...

Language: en