TY  - JOUR
PY  - 2018//
TI  - Hidden costs of hospitalization after firearm injury: national analysis of different hospital readmission
JO  - Annals of surgery
A1  - Rattan, Rishi
A1  - Parreco, Joshua
A1  - Namias, Nicholas
A1  - Pust, Gerd D.
A1  - Yeh, D. Dante
A1  - Zakrison, Tanya L.
SP  - 810
EP  - 815
VL  - 267
IS  - 5
N2  - OBJECTIVE: To compare the risk factors and costs associated with readmission after firearm injury nationally, including different hospitals. <br><br>BACKGROUND: No national studies capture readmission to different hospitals after firearm injury. <br><br>METHODS: The 2013 to 2014 Nationwide Readmissions Database was queried for patients admitted after firearm injury. Logistic regression identified risk factors for 30-day same and different hospital readmission. Cost was calculated. Survey weights were used for national estimates. <br><br>RESULTS: There were 45,462 patients admitted for firearm injury during the study period. The readmission rate was 7.6%, and among those, 16.8% were readmitted to a different hospital. Admission cost was $1.45 billion and 1-year readmission cost was $131 million. Sixty-four per cent of those injured by firearms were publicly insured or uninsured. Readmission predictors included: length of stay >7 days [odds ratio (OR) 1.43, P < 0.01], Injury Severity Score >15 (OR 1.41, P < 0.01), and requiring an operation (OR 1.40, P < 0.01). Private insurance was a predictor against readmission (OR 0.81, P < 0.01). Predictors of readmission to a different hospital were unique and included: initial admission to a for-profit hospital (OR 1.52, P < 0.01) and median household income ≥$64,000 (OR 1.48, P < 0.01). <br><br>CONCLUSIONS: A significant proportion of the national burden of firearm readmissions is missed by not tracking different hospital readmission and its unique set of risk factors. Firearm injury-related hospitalization costs $791 million yearly, with the largest fraction paid by the public. This has implications for policy, benchmarking, quality, and resource allocation.<p />  <p>Language: en</p>
LA  - en
SN  - 0003-4932
UR  - http://dx.doi.org/10.1097/SLA.0000000000002529
ID  - ref1
ER  -