Economic and Educational Impact of Firearm-Related Injury on an Urban Trauma Center.

As nonfatal firearm-related injuries continue to increase, calculating the financial cost these injuries have on an urban trauma center may help justify funding for intervention programs. The impact these injuries have on orthopedic resident education may lead to changes in the training of some urban-based programs. This is a retrospective review of patients with an acute firearm-related injury from 2007 to 2013 at Louisiana State University Interim Public Hospital in New Orleans, Louisiana. All patients with a diagnosis of an acute gunshot wound on presentation to the emergency department were included in the study. Patients with complications from a previous gunshot wound or treatment of that wound were excluded. A total of 3617 patient encounters were identified that met this criteria. The total amount billed by the hospital over the study period was $141,995,682 while collecting $30,922,953. The actual hospital costs from these encounters was $73,572,892, giving the hospital a loss of $42,649,938. Of the 3617 patient encounters, 59% required orthopedic consultation. Of that consultation group, 25% required inpatient orthopedic surgical intervention. Acute gunshot wounds accounted for 23% of orthopedic trauma consultations and 13% of the orthopedic daily census. The financial data provide justification from an economic perspective for funding intervention programs aimed at decreasing firearm-related injury. In addition, the proportion of orthopedic surgical training spent on firearm-related injury provides program directors of urban-based programs with valuable information, although no conclusions can be drawn as to the effect on orthopedic surgical education.