Davoudi Anis, Woodworth Lindsey
Department of Epidemiology, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
Department of Economics, University of South Carolina, 1014 Greene Street, Columbia, SC, 29208, USA.
Inj Epidemiol. 2023 Mar 1;10(1):12. doi: 10.1186/s40621-023-00420-1.
Firearm injuries are a long-running yet preventable public health concern in the USA. We analyzed national inpatient data to determine the burden of firearm injuries on the USA hospital system. For each year from 2000-2014 and 2016-2020, we calculated the annual frequency of firearm hospitalization in the USA overall and by the intent of the shooter. We also calculated the rate of firearm hospitalizations per 100,000 inpatient encounters. For each outcome, we used regression analysis to estimate the average year-over-year change. Finally, we explored the types of firearms responsible for firearm hospitalizations.
Each year during 2000-2020 (excluding 2015), there were an average of 30,428 firearm hospitalizations in the USA. On average, firearm hospitalizations represented 84 out of every 100,000 inpatient encounters each year. There was not a statistically significant year-over-year increase in firearm hospitalizations for either the periods 2000-2014 or 2016-2020. However, firearm hospitalizations were noticeably higher in 2020 than in other years. Until 2019, the most frequent intent among firearm hospitalizations was assault. Beginning in 2019, assaults were outnumbered by unintentional firearm hospitalizations. According to diagnosis codes, handguns were used more often than rifles/shotguns/larger firearms in firearm injuries that resulted in hospitalization for the intents assault (27.93% handguns; 5.87% rifles/shotguns/larger firearms), unintentional (23.94% handguns; 10.48% rifles/shotguns/larger firearms), self-harm (46.63% handguns; 14.35% rifles/shotguns/larger firearms) and undetermined (17.82% handguns; 6.21% rifles/shotguns/larger firearms). Frequently, the type of firearm responsible for the hospitalization was not recorded in the patient's diagnosis code.
Firearm injuries inflict a significant burden on the hospital system in the USA. While firearm hospitalizations were unusually high in 2020, there is not strong evidence that the burden of firearm injuries on the hospital system is changing over time. The frequent non-identification of the type of firearm responsible for the injury in hospital patients' diagnosis code complicates injury surveillance efforts.
在美国，枪支伤害是一个长期存在但可预防的公共卫生问题。我们分析了全国住院患者数据，以确定枪支伤害对美国医院系统造成的负担。对于2000年至2014年以及2016年至2020年的每一年，我们计算了美国总体以及按枪手意图划分的枪支住院治疗的年度频率。我们还计算了每10万次住院患者就诊中的枪支住院治疗率。对于每个结果，我们使用回归分析来估计平均逐年变化。最后，我们探究了导致枪支住院治疗的枪支类型。
在2000年至2020年期间（不包括2015年），美国每年平均有30428例枪支住院治疗病例。平均而言，枪支住院治疗病例每年占每10万次住院患者就诊病例中的84例。在2000年至2014年或2016年至2020年期间，枪支住院治疗病例数均没有统计学上显著的逐年增加。然而，2020年的枪支住院治疗病例数明显高于其他年份。直到2019年，枪支住院治疗病例中最常见的意图是袭击。从2019年开始，非故意枪支住院治疗病例数超过了袭击病例数。根据诊断编码，在因袭击（手枪占27.93%；步枪/霰弹枪/大型枪支占5.87%）意图、非故意（手枪占23.94%；步枪/霰弹枪/大型枪支占10.48%）、自残（手枪占46.63%；步枪/霰弹枪/大型枪支占14.35%）和情况不明（手枪占17.82%；步枪/霰弹枪/大型枪支占6.21%）导致住院治疗的枪支伤害中，手枪的使用频率高于步枪/霰弹枪/大型枪支。通常，导致住院治疗的枪支类型在患者的诊断编码中未被记录。
枪支伤害给美国的医院系统带来了沉重负担。虽然2020年的枪支住院治疗病例数异常高，但没有有力证据表明医院系统所承受的枪支伤害负担随时间而变化。医院患者诊断编码中经常未明确导致伤害的枪支类型，这使伤害监测工作变得复杂。
