Special Populations

Most individuals hospitalized for gunshot wounds are young and poor, and more than one-fourth have no insurance

Gunshot injuries are the second leading cause of death due to injury after motor vehicle accidents. Victims of gunshot injuries who are hospitalized often are uninsured and typically stay in the hospital for nearly a week. Most (86 percent) hospitalized victims are males, nearly half (47 percent) are younger than 25 years of age, 29 percent are uninsured, and 25 percent are insured by Medicaid. Those are the findings of a study by Jeffrey H. Coben, M.D., of Allegheny General Hospital, Pittsburgh, and Claudia A. Steiner, M.D., M.P.H., of the Agency for Healthcare Research and Quality. Formerly, Dr. Coben was AHRQ's senior scholar in residence for domestic violence.

Drs. Coben and Steiner analyzed data on these types of injuries using the 1997 Nationwide Inpatient Sample, a probability sample of 1,012 nonfederal community hospitals from 22 States, which is part of the Healthcare Cost and Utilization Project (HCUP). HCUP is a Federal-State-industry partnership, including public and private State data organizations. The researchers examined HCUP codes for external cause of injury (E codes) to identify firearm-related injuries.

They estimated 35,810 hospitalizations for gunshot-related injuries nationwide in 1997. The mean length of stay (LOS) for all patients with firearm-related injuries was 6 days. However, self-inflicted gunshot injuries had the longest mean LOS, an average of 8 days. About 60 percent of all patients were less than 30 years of age, and 7 percent died during hospitalization.

Estimated hospital charges for firearm-related injuries in the United States in 1997 totaled over $802 million, reflecting the often catastrophic consequences of gunshot wounds. In 1997, these injuries resulted in 2,500 intracranial injuries, 669 spinal cord injuries, and 1,000 small bowel resections. Over 60 percent of patients underwent more than two procedures while in the hospital. The majority of patients admitted with firearm-related injuries lived in low-income areas and were admitted to large urban teaching hospitals.

See "Hospitalizations for firearm-related injuries in the United States, 1997," by Drs. Coben and Steiner, in the American Journal of Preventive Medicine 24(1), pp. 1-8, 2003.

Reprints (AHRQ Publication No. 03-R025) are available from the AHRQ Publications Clearinghouse and AHRQ InstantFax.


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