Department of Psychiatry, University of Michigan, United States of America.
Injury Prevention Center, University of Michigan, United States of America; Department of Emergency Medicine, University of Michigan, United States of America.
Prev Med. 2023 Oct;175:107681. doi: 10.1016/j.ypmed.2023.107681. Epub 2023 Aug 24.
In 2020, firearm injury became the leading cause of death in U.S. children and adolescents. This study examines sequelae of firearm injury among children and adolescents in terms of health care costs and use within a family over time using an event study design. Using data from a large U.S. commercial insurance company from 2013 to 2019, we identified 532 children and adolescents aged 1-19 years who experienced any firearm-related acute hospitalization or emergency department (ED) encounter and 1667 of their family members (833 parents and 834 siblings). Outcomes included total health care costs, any acute hospitalization and ED visits (yes/no), and number of outpatient management visits, each determined on a quarterly basis 2 years before and 3 years after the firearm injury. Among injured children and adolescents, during the first quarter after the firearm injury, quarterly total health care costs were $24,018 higher than pre-injury; probability of acute hospitalization and ED visits were 27.9% and 90.4% higher, respectively; and number of outpatient visits was 1.8 higher (p < .001 for all). Quarterly total costs continued to be elevated during the second quarter post-injury ($1878 higher than pre-injury, p < .01) and number of outpatient visits remained elevated throughout the first year post-injury (0.6, 0.4, and 0.3 higher in the second through fourth quarter, respectively; p < .05 for all). Parents' number of outpatient visits increased during the second and third years after the firearm injury (0.3 and 0.5 higher per quarter than pre-injury; p < .05). Youth firearm injury has long-lasting impact on health care within a family.
2020 年，枪支伤害成为美国儿童和青少年的主要死因。本研究采用事件研究设计，从医疗保健费用和家庭内使用的角度，考察了枪支伤害对儿童和青少年的后遗症。利用一家美国大型商业保险公司 2013 年至 2019 年的数据，我们确定了 532 名年龄在 1-19 岁的经历过任何枪支相关急性住院或急诊（ED）就诊的儿童和青少年，以及他们的 1667 名家庭成员（833 名父母和 834 名兄弟姐妹）。结果包括总医疗保健费用、任何急性住院和 ED 就诊（是/否），以及门诊管理就诊次数，所有这些都是在枪支伤害前 2 年和后 3 年每季度确定的。在受伤的儿童和青少年中，在枪支伤害后的第一个季度，季度总医疗保健费用比受伤前高出 24018 美元；急性住院和 ED 就诊的概率分别高出 27.9%和 90.4%；门诊就诊次数高出 1.8 次（所有 p 值均<0.001）。受伤后第二个季度的季度总费用仍居高不下（比受伤前高出 1878 美元，p<0.01），并且在受伤后第一年门诊就诊次数一直居高不下（在第二至第四季度分别高出 0.6、0.4 和 0.3 次；所有 p 值均<0.05）。父母的门诊就诊次数在枪支伤害后的第二年和第三年增加（比受伤前每季度高出 0.3 和 0.5 次；p<0.05）。青少年枪支伤害对家庭内的医疗保健有长期影响。
