J. S. Taylor1, S. Madhavan2, J. M. Chandler1, S. D. Chao1 1Stanford University,Pediatric Surgery / Surgery / Stanford School Of Medicine,Stanford, CA, USA 2Stanford University,Statistics,Stanford, CA, USA
Introduction: Pediatric firearm-related injuries pose a significant public health problem within the U.S., yet the financial burden associated with these injuries has not been well-described. This study examined the incidence of pediatric firearm-related injuries and the cost associated with the initial hospitalization.
Methods: The Healthcare Cost and Utilization Project Kids’ Inpatient Database (KID) from the years 2003, 2006, 2009, and 2012 was used to identify all patients under 21 years of age who were admitted with firearm-related injuries. We compared demographic and discharge-level data including injury severity score (ISS), hospital length of stay (LOS), income quartile, injury intent, inflation-adjusted hospital costs across age groups (0-5, 6-9, 10-15, 16-20 years).
Results: There were 8,196 ± 1,095 pediatric firearm-related admissions each year, with an average hospital cost of $24,686 ± $2,318 per patient. Annual initial hospitalization costs for pediatric firearm injuries were approximately $189 million dollars during the study period. Pediatric firearm-related injuries predominately occur among older teenagers (84%, 16-20 years), males (90%), black individuals (56%), or those from the lowest income quartile (53%). We found significant cost variation based on patient race, income quartile, ISS, intent, LOS, disposition, and hospital region. Inflation-adjusted hospitalization costs have increased significantly over the study period (p < 0.001).
Figure 1. A) Intent of pediatric firearm-related injuries by race. B) Intent of pediatric firearm-related injuries by age group. C) Average hospital cost per admission for pediatric firearm-related injuries by payer type. All data from 2003-2012.
Conclusion: Pediatric firearm-related injuries are a large financial burden to the U.S. healthcare system. There are significant variations in cost based on predictable factors like hospital LOS and ISS; however, there are also substantial discrepancies based on hospital region, patient race and income quartile that require further investigation.
