@article{ref1,
title="Increases in actual health care costs and claims after firearm injury",
journal="Annals of internal medicine",
year="2020",
author="Ranney, Megan L. and Herges, Curtis and Metcalfe, Leanne and Schuur, Jeremiah D. and Hain, Paul and Rowhani-Rahbar, Ali",
volume="173",
number="12",
pages="949-955",
abstract="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.<p /> <p>Language: en</p>",
language="en",
issn="0003-4819",
doi="10.7326/M20-0323",
url="http://dx.doi.org/10.7326/M20-0323"
}