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 Medicaid and Medicare pay 41 percent of the total, and private
insurers another 20 percent, the study authors report in American
Journal of Public Health.
“Firearm-related injuries are at the heart of one of the most heated
political discussions in the United States, yet there is
surprisingly little scientific research available on the subject,”
said lead study author Sarabeth Spitzer of the Stanford University
School of Medicine in California.
“It is important for all parties involved in these discussions to
have a clear understanding of the monetary cost of these injuries
and where the financial burden falls,” she told Reuters Health by
email.
In 2014, firearms caused about 33,700 deaths and 81,000 nonfatal
injuries in the U.S., according to the Centers for Disease Control
and Prevention. The U.S. homicide rate is seven times higher than
that of other developed countries, and the gun homicide rate is 25
times higher, Spitzer and her co-authors note.
To get a conservative estimate of the costs of firearm injuries, the
researchers analyzed data from the largest U.S. database of
inpatient hospital care. They focused on emergency treatment of
firearm injuries that led to hospital admission, excluding
readmissions for an older injury or patients who were treated but
not admitted.
Between 2006 and 2014, about 267,000 patients were admitted for
firearm-related injuries, and inflation-adjusted costs totaled $6.61
billion. Average costs per admission ranged from $19,600 for
self-pay patients to $30,900 for Medicaid patients.
“This study underestimates the true cost of firearm-related injuries
as it includes only the first inpatient admission cost,” Spitzer
said. “It excludes many other important and costly steps in patient
treatment such as emergency department care, readmission,
rehabilitation, long-term health care and disability.”
The injury patients were overwhelmingly male across all payer
groups. Patients insured by Medicaid, the federal-state insurance
program for the poor, stayed in the hospital for an average three
days longer than others and had injuries that were more likely to
have been caused by assault.
Patients covered by Medicare, the federal health insurance program
for people over age 65, were more likely to have self-inflicted
injuries and privately-insured patients had more unintentional
injuries.
About 43 percent of all hospital admissions were in the South, which
also had the highest proportion of self-pay patients. The Northeast
had the lowest proportion of admissions with 16 percent.
Of the inflation-adjusted $6.6 billion costs during the study
period, Medicaid paid $2.3 billion, or 34.8 percent; Medicare paid
$0.4 billion, or 6 percent; private insurers paid $1.32 billion, or
34.8 percent; and self-pay individuals paid $1.56 billion or 23.6
percent.
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“We’re an outlier nation in terms of gun problems, and this only
looks at a small part of the expense,” said David Hemenway of
Harvard University in Boston who wasn’t involved with the study.
The study doesn’t include costs related to long-term issues such as
spinal cord injuries and traumatic brain injury, as well as social
or job-related costs, such as unemployment, sick leave and
psychological impact on loved ones, noted Hemenway, who directs the
Harvard Injury Control Research Center.
“It doesn’t even begin to account for the real costs of losing a
relative, spouse or community member,” he added. “Gun violence makes
it impossible to live a good life in some of these places,
especially when industry doesn’t want to move in and people are
afraid to go out.”
As the first study to quantify firearm-related costs in about a
decade, the data could have major implications for public policy
changes and healthcare funding, said Konstantinos Economopoulos of
Massachusetts General Hospital in Boston, who was not involved in
the research. In the past 30 years of funding from the National
Institutes of Health, for example, six awards have supported
firearm-injury studies, he said.
“The financial burden . . . falls mainly on the shoulders of the
government (through Medicaid) and the uninsured,” he told Reuters
Health by email. “There is an ethical - but also financial -
imperative need for an increase in funding for future research to
tackle the ongoing epidemic of firearm-related injuries.”
SOURCE: http://bit.ly/2octnE0 American Journal of Public Health,
online March 21, 2017.
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reserved.] Copyright 2017 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
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