Jiang Yongwen, Ranney Megan L, Sullivan Brian, Hilliard Dennis, Viner-Brown Samara, Alexander-Scott Nicole
Rhode Island Department of Health, Center for Health Data and Analysis, Providence, Rhode Island (Dr Jiang and Ms Viner-Brown); Departments of Epidemiology (Dr Jiang) and Health Services, Policy and Practice (Drs Ranney and Alexander-Scott), School of Public Health, Brown University, Providence, Rhode Island; Injury Prevention Center at Rhode Island Hospital, Providence, Rhode Island (Dr Ranney); Department of Emergency Medicine, Emergency Digital Health Innovation Program, Alpert School of Medicine, Brown University, Providence, Rhode Island (Dr Ranney); Lincoln Police Department, Lincoln, Rhode Island (Mr Sullivan); Rhode Island State Crime Laboratory, University of Rhode Island, Kingston, Rhode Island (Mr Hilliard); Rhode Island Department of Health, Providence, Rhode Island (Dr Alexander-Scott); and Department of Pediatrics and Medicine, Warren Alpert Medical School, Brown University, Providence, Rhode Island (Dr Alexander-Scott).
J Public Health Manag Pract. 2019 Mar/Apr;25(2):137-146. doi: 10.1097/PHH.0000000000000744.
National data on the epidemiology of firearm injuries and circumstances of firearm deaths are difficult to obtain and often are nonreliable. Since firearm injury and death rates and causes can vary substantially between states, it is critical to consider state-specific data sources.
In this study, we illustrate how states can systematically examine demographic characteristics, firearm information, type of wound, toxicology tests, precipitating circumstances, and costs to provide a comprehensive picture of firearm injuries and deaths using data sets from a single state with relatively low rates of firearm injury and death.
Cross-sectional study.
Firearm-related injury data for the period 2005-2014 were obtained from the Rhode Island emergency department and hospital discharge data sets; death data for the same period were obtained from the Rhode Island Violent Death Reporting System.
Descriptive statistics were used. Healthcare Cost and Utilization Project cost-to-charge ratios were used to convert total hospital charges to costs.
Most firearm-related emergency department visits (55.8%) and hospital discharges (79.2%) in Rhode Island were from assaults; however, most firearm-related deaths were suicides (60.1%). The annual cost of firearm-related hospitalizations was more than $830 000. Most decedents who died because of firearms tested positive for illicit substances. Nearly a quarter (23.5%) of firearm-related homicides were due to a conflict between the decedent and suspect. More than half (59%) of firearm suicide decedents were reported to have had current mental or physical problems prior to death.
Understanding the state-specific magnitude and patterns (who, where, factors, etc) of firearm injury and death may help inform local injury prevention efforts. States with similar data sets may want to adopt our analyses. Surveillance of firearm-related injury and death is essential. Dissemination of surveillance findings to key stakeholders is critical in improving firearm injury prevention. States that are not part of the National Violent Death Reporting System (NVDRS) could work with their other data sources to obtain a better picture of violent injuries and deaths to make the best use of resources.
关于枪支伤害的流行病学及枪支死亡情况的全国性数据难以获取且往往不可靠。由于各州之间的枪支伤害和死亡率及原因可能存在很大差异，考虑各州特定的数据源至关重要。
在本研究中，我们阐述了各州如何利用来自一个枪支伤害和死亡率相对较低的单一州的数据集，系统地研究人口统计学特征、枪支信息、伤口类型、毒理学检测、诱发情况及成本，以全面了解枪支伤害和死亡情况。
横断面研究。
2005 - 2014年期间与枪支相关的伤害数据来自罗德岛急诊科和医院出院数据集；同期的死亡数据来自罗德岛暴力死亡报告系统。
采用描述性统计。利用医疗保健成本与利用项目的成本收费比将医院总收费转换为成本。
罗德岛大多数与枪支相关的急诊科就诊（55.8%）和医院出院（79.2%）是由袭击所致；然而，大多数与枪支相关的死亡是自杀（60.1%）。与枪支相关的住院年度成本超过83万美元。大多数因枪支死亡的死者非法物质检测呈阳性。近四分之一（23.5%）与枪支相关的杀人案是由于死者与嫌疑人之间的冲突。超过一半（59%）的枪支自杀死者在死亡前被报告患有当前的精神或身体问题。
了解特定州枪支伤害和死亡的规模及模式（何人、何地、因素等）可能有助于为当地的伤害预防工作提供信息。拥有类似数据集的州可能希望采用我们的分析方法。对与枪支相关的伤害和死亡进行监测至关重要。将监测结果传播给关键利益相关者对于改善枪支伤害预防至关重要。未加入国家暴力死亡报告系统（NVDRS）的州可以与其他数据源合作，以更好地了解暴力伤害和死亡情况，从而充分利用资源。
