Hospitalizations for firearm-related injuries. A population-based study of 9562 patients
M. J. Vassar and K. W. Kizer
School of Medicine, University of California, Davis, USA.
OBJECTIVE--To determine the incidence, nature, demographics, severity, and
hospital charges associated with inpatient treatment of firearm-related
injuries. DESIGN--A retrospective, 1-year, population-based study of
firearm-related hospitalizations based on the 1991 California Hospital
Discharge Abstract Data Tapes. SETTING--California acute care hospitals
that reported firearm-related discharges. PATIENTS--A total of 9562
patients discharged with firearm-related injuries. MAIN OUTCOME
MEASURES--Per capita hospital discharge rates, according to age, race, and
sex. RESULTS--A total of 9562 firearm-injured persons were discharged from
California hospitals in 1991, representing a rate of 32 discharges per 100
000 population. Males aged 15 to 24 years accounted for 72% of the
hospitalizations. For all causes of firearm-related injury, the highest
age- and race-specific discharge rate was 439 per 100,000 for black persons
aged 15 to 24 years. The highest county discharge rate was 55 per 100,000
for Los Angeles County. Statewide, there were 1.8 hospital discharges per
firearm-related fatality (both in the hospital and in the community).
Assaults accounted for 74% of cases. Among black males aged 15 to 24 years,
assaults accounted for 598 discharges per 100 000 population. Hospital
charges for 9193 patients exceeded $164 million; mean and median charges
per patient discharged were $17,888 and $8535, respectively. Publicly
financed health insurance programs sponsored 56% of patients; 25% had
private insurance, and 19% were uninsured. Fifty-three percent of the
discharges occurred at 13 of the 371 hospitals that discharged patients
with firearm-related injuries. CONCLUSIONS--Firearm-related violence is a
major cause of hospitalization of young urban black males and represents a
significant cost to publicly financed health care. The impact on individual
hospitals is highly disproportionate. While hospital discharge data can be
used for population-based surveillance of firearm-related trauma, there is
need for improvement in local, state, and national surveillance of these
injuries.
