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Citation
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Ranney ML, Herges C, Metcalfe L, Schuur JD, Hain P, Rowhani-Rahbar A. Ann. Intern Med. 2020; 173(12): 949-955. |
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Abstract
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BACKGROUND:
The incidence of firearm injury and death in the United States is increasing. Although the health care-related effect of firearm injury is estimated to be high, existing data are largely cross-sectional, do not include data on preinjury and postinjury health care visits and related costs, and use hospital charges rather than actual monetary payments.
Objective:
To compare actual health care costs (that is, actual monetary payments) and utilizations within the 6 months before and after an incident (index) firearm injury.
Design:
Before-after study.
Setting:
Blue Cross Blue Shield plans of Illinois, Texas, Oklahoma, New Mexico, and Montana.
Participants:
Plan members continuously enrolled for at least 12 months before and after an index firearm injury sustained between 1 January 2015 and 31 December 2017.
Measurements:
Eligible costs, out-of-pocket costs, and firearm injury-related International Classification of Diseases, Ninth or 10th Revision, codes.
Results:
Total initial (emergency department [ED]) health care costs for persons with index firearm injuries who were discharged from the ED were $8 158 786 ($5686 per member). Total initial (hospital admission) costs for persons with index firearm injuries who required hospitalization were $41 255 916 ($70 644 per member). Compared with the 6 months before the index firearm injury, in the 6 months after, per-member costs increased by 347% (from $3984 to $17 806 per member) for those discharged from the ED and 2138% (from $4118 to $92 151 per member) for those who were hospitalized. The number of claims increased by 187% for patients discharged from the ED and 608% for those who were hospitalized.
Limitation:
Firearm injury intent was not specified because of misclassification concerns.
Conclusion:
In the 6 months after a firearm injury, patient-level health care visits and costs increased by 3 to 20 times compared with the 6 months prior. The burden of firearm injury on the health care system is large and quantifiable.
Primary Funding Source:
None.
Language: en |