Health Care Use, Costs Increase 20-Fold After Firearm Injury

TUESDAY, Sept. 29, 2020 — Actual health care costs increase up to 20-fold in the six months after a gunshot injury versus the six months before, according to a study published online Sept. 29 in the Annals of Internal Medicine.

Megan L. Ranney, M.D., M.P.H., from Brown University in Providence, Rhode Island, and colleagues compared actual health care costs (actual monetary payments) and utilizations within the six months before and after an incident (index) firearm injury. The analysis included all Blue Cross Blue Shield members in Illinois, Texas, Oklahoma, New Mexico, and Montana who were continuously enrolled for at least 12 months before and after an index firearm injury (2015 through 2017).

The researchers found that total initial (emergency department) health care costs for persons with index firearm injuries who were discharged from the emergency department were $8,158,786 (or $5,686 per member). Among persons with index firearm injuries who required hospitalization, total initial hospital admission costs were $41,255,916 (or $70,644 per member). In the six months after an index firearm injury, per-member costs increased by 347 percent versus the six months before injury (from $3,984 to $17,806 per member) for those discharged from the emergency department, while there was a 2,138 percent increase (from $4,118 to $92,151 per member) for those who were hospitalized. For patients discharged from the emergency department, the number of claims increased by 187 percent, while the increase was 608 percent for those who were hospitalized. Mental health claims increased by 100 to 300 percent after an injury, depending on patient disposition.

“Findings of this investigation can contribute to the development, refinement, and economic justification of firearm injury prevention priorities promoted by health care systems, organizations, and practitioners,” the authors write.

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