Royan Regina, Lundberg Alexander, Shan Ying, Thomas Arielle C, Stey Anne M
Department of Emergency Medicine, University of Michigan, Ann Arbor.
Buehler Center for Health Policy and Economics, Northwestern University, Chicago, Illinois.
JAMA Health Forum. 2025 Sep 5;6(9):e253299. doi: 10.1001/jamahealthforum.2025.3299.
Firearm injury is a leading cause of mortality in the US. Contemporary firearm injury health care costs and characteristics of hospital visits can inform investment decisions on treatment and prevention strategies.
To estimate the total health care cost of new firearm injury hospital visits from 2016 to 2021 in the US.
DESIGN, SETTING, AND PARTICIPANTS: This economic evaluation study via Monte Carlo simulation included data from the Arkansas, Florida, Maryland, Massachusetts, New York, and Wisconsin Healthcare Cost and Utilization Project State Inpatient and Emergency Department databases from 2016 to 2021. Children and adults with an inpatient or emergency department (ED) hospital visit for new firearm injuries were included. Data were analyzed from June 2023 to May 2025.
Firearm-related inpatient or ED visits with new firearm injury International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) diagnosis codes.
A Monte Carlo simulation used new inpatient and ED firearm injury visits in 6 sample states to estimate the national health care cost for the treatment of initial firearm injuries from 2016 to 2021. The simulation also used national inpatient data from the RAND Corporation for nonsample states. Costs were adjusted for inflation to 2024 US dollars. Costs to each body region were derived from the Injury Mortality Diagnosis Matrix classification scheme.
The Monte Carlo analysis included 2400 simulations. Firearm injuries in the US led to an estimated 298 721 ED visits and 185 846 inpatient visits, with a total health care cost of $7.7 billion from 2016 to 2021. Inpatient admissions accounted for 93% of the cost, or $7.2 billion. Treatment for children younger than 18 years accounted for 9% of the cost, or $684 million. Annual ED and inpatient visits were both approximately stable from 2016 to 2019, at which point they grew by 42% and 40%, respectively, from 2019 to 2021. Annual total health care cost was also stable at approximately $1.2 billion until 2019, when cost began to grow to a peak of $1.6 billion in 2021. The mean (SE) ED visit cost was $1743 (4.5), and the mean (SE) inpatient admission cost was $38 879 (138.9). These costs remained stable annually over the sample period.
In this economic evaluation study, an increase in firearm injuries in the last 6 years paralleled an increase in costs from 2016 to 2021.
枪支伤害是美国主要的死亡原因之一。当代枪支伤害的医疗保健成本以及医院就诊的特征可为治疗和预防策略的投资决策提供参考。
估算2016年至2021年美国因新发枪支伤害而进行医院就诊的总医疗保健成本。
设计、背景和参与者：这项通过蒙特卡洛模拟进行的经济评估研究纳入了2016年至2021年阿肯色州、佛罗里达州、马里兰州、马萨诸塞州、纽约州和威斯康星州医疗保健成本与利用项目的州住院患者和急诊科数据库中的数据。纳入了因新发枪支伤害而进行住院或急诊科就诊的儿童和成人。数据于2023年6月至2025年5月进行分析。
具有新发枪支伤害的国际疾病分类第十版（ICD - 10）诊断代码的与枪支相关的住院或急诊科就诊。
蒙特卡洛模拟使用6个样本州的新发住院和急诊科枪支伤害就诊情况来估算2016年至2021年全国治疗初始枪支伤害的医疗保健成本。该模拟还使用了兰德公司提供的非样本州的全国住院患者数据。成本经通胀调整至2024年美元。每个身体部位的成本源自伤害死亡率诊断矩阵分类方案。
蒙特卡洛分析包括2400次模拟。2016年至2021年，美国的枪支伤害导致估计298721次急诊科就诊和185846次住院就诊，总医疗保健成本达77亿美元。住院治疗占成本的93%，即72亿美元。18岁以下儿童的治疗费用占成本的9%，即6.84亿美元。2016年至2019年，急诊科和住院就诊次数每年大致稳定，到2019年至2021年，分别增长了42%和40%。2019年之前，年度总医疗保健成本也大致稳定在约12亿美元，之后成本开始增长，到2021年达到16亿美元的峰值。急诊科就诊的平均（标准误）成本为1743美元（4.5），住院治疗的平均（标准误）成本为38879美元（138.9）。在样本期内，这些成本每年保持稳定。
在这项经济评估研究中，2016年至2021年枪支伤害增加的同时，成本也相应增加。
