Allard D, Burch V C
Department of Surgery, G F Jooste Hospital, Cape Town.
S Afr Med J. 2005 Aug;95(8):591-4.
Firearms, the leading external cause of non-natural deaths in South Africa, claim approximately 15,000 lives annually. Up to 127,000 firearm-injured victims seek state health care assistance per annum. The fiscal burden of treating these injuries is not known.
All serious abdominal firearm-related injuries (requiring admission to hospital and emergency surgery) presenting to a state hospital over a 6-month period were reviewed. A cost analysis using five variables was performed: operating theatre time, duration of hospital and high-care unit stay, pharmaceutical and blood products used, laboratory services used and diagnostic imaging studies performed.
Twenty-three patients with serious abdominal gunshot injuries were admitted, of whom 21 (91%) were treated at the hospital from admission until discharge. Each admission cost approximately US dollars 1,467. Hospital stay (47%) and operating theatre (30%) costs accounted for most of the total cost. Pharmaceuticals and blood products (20%), laboratory services (2%) and imaging studies (1%) contributed less than 25% to the total cost.
Serious abdominal gunshot injuries cost at least 13-fold more than the annual per capita South African government expenditure on health. This fiscal burden of approximately US dollars 2.9 million, almost 4% of the annual health budget, does not include the cost of treating other serious gunshot injuries. These findings highlight the need for successful violence prevention strategies in South African.
枪支是南非非自然死亡的主要外部原因，每年导致约15000人死亡。每年有多达127000名受枪支伤害的受害者寻求国家医疗保健援助。治疗这些伤害的财政负担尚不清楚。
回顾了在一家国立医院6个月期间出现的所有与枪支相关的严重腹部损伤（需要住院和急诊手术）。使用五个变量进行了成本分析：手术室时间、住院和重症监护病房停留时间、使用的药品和血液制品、使用的实验室服务以及进行的诊断成像研究。
收治了23例严重腹部枪伤患者，其中21例（91%）在医院接受了从入院到出院的治疗。每次住院费用约为1467美元。住院（47%）和手术室（30%）费用占总费用的大部分。药品和血液制品（20%）、实验室服务（2%）和成像研究（1%）占总费用的比例不到25%。
严重腹部枪伤的治疗成本至少是南非政府每年人均卫生支出的13倍。这一约290万美元的财政负担，几乎占年度卫生预算的4%，不包括治疗其他严重枪伤的费用。这些发现凸显了南非成功预防暴力战略的必要性。
