Human and economic costs of pediatric firearm injury.

PURPOSE

Pediatric firearm injury is a national crisis that inflicts significant trauma. No studies have captured risk factors for readmissions after firearm injury, including cost analysis.

METHODS

Nationwide Readmissions Database (2010-2014) was queried for patients <18 years admitted after acute firearm injury. Outcomes included mortality, length of stay, hospital costs, and readmission rates (30-day and 1-year). Multivariable logistic regression identified risk factors, significance set at p < 0.05.

RESULTS

There were 13,596 children admitted for firearm injury. Mortality rate was 6% (n = 797). Self-inflicted injury was the most lethal (37%, n = 218) followed by unintentional (5%, n = 186), and assault (4%, n = 340), all p < 0.01. Readmission rates at 30 days and 1-year were 6% (12% to different hospital) and 12% (19% to different hospital), respectively. Medicaid patients were more frequently readmitted to the index hospital, whereas self-pay and/or high income were readmitted to a different hospital. The total hospitalizations cost was over $382 million, with $5.4 million due to readmission to a different hospital.

CONCLUSION

While guns cause significant morbidity, disability, and premature mortality in children, they also have a substantial economic impact. This study quantifies the previously unreported national burden of readmission costs and discontinuity of care for this preventable public health crisis.

TYPE OF STUDY

Retrospective Comparative Study.

LEVEL OF EVIDENCE

Level III.