Vassar M J, Kizer K W
School of Medicine, University of California, Davis, USA.
JAMA. 1996 Jun 12;275(22):1734-9.
To determine the incidence, nature, demographics, severity, and hospital charges associated with inpatient treatment of firearm-related injuries.
A retrospective, 1-year, population-based study of firearm-related hospitalizations based on the 1991 California Hospital Discharge Abstract Data Tapes.
California acute care hospitals that reported firearm-related discharges.
A total of 9562 patients discharged with firearm-related injuries.
Per capita hospital discharge rates, according to age, race, and sex.
A total of 9562 firearm-injured persons were discharged from California hospitals in 1991, representing a rate of 32 discharges per 100 000 population. Males aged 15 to 24 years accounted for 72% of the hospitalizations. For all causes of firearm-related injury, the highest age- and race-specific discharge rate was 439 per 100,000 for black persons aged 15 to 24 years. The highest county discharge rate was 55 per 100,000 for Los Angeles County. Statewide, there were 1.8 hospital discharges per firearm-related fatality (both in the hospital and in the community). Assaults accounted for 74% of cases. Among black males aged 15 to 24 years, assaults accounted for 598 discharges per 100 000 population. Hospital charges for 9193 patients exceeded $164 million; mean and median charges per patient discharged were $17,888 and $8535, respectively. Publicly financed health insurance programs sponsored 56% of patients; 25% had private insurance, and 19% were uninsured. Fifty-three percent of the discharges occurred at 13 of the 371 hospitals that discharged patients with firearm-related injuries.
Firearm-related violence is a major cause of hospitalization of young urban black males and represents a significant cost to publicly financed health care. The impact on individual hospitals is highly disproportionate. While hospital discharge data can be used for population-based surveillance of firearm-related trauma, there is need for improvement in local, state, and national surveillance of these injuries.
确定与火器相关损伤住院治疗相关的发病率、性质、人口统计学特征、严重程度及医院费用。
基于1991年加利福尼亚医院出院摘要数据磁带，对与火器相关的住院情况进行为期1年的回顾性、基于人群的研究。
报告了与火器相关出院情况的加利福尼亚急性护理医院。
共有9562例因火器相关损伤出院的患者。
按年龄、种族和性别划分的人均医院出院率。
1991年共有9562名火器受伤者从加利福尼亚医院出院，相当于每10万人口中有32例出院。15至24岁的男性占住院人数的72%。对于所有火器相关损伤原因，15至24岁黑人的最高年龄和种族特异性出院率为每10万人口中有439例。洛杉矶县的最高县出院率为每10万人口中有55例。在全州范围内，每例与火器相关的死亡（包括在医院和社区）有1.8例医院出院。袭击占病例的74%。在15至24岁的黑人男性中，袭击导致每10万人口中有598例出院。9193例患者的医院费用超过1.64亿美元；出院患者的平均费用和中位数费用分别为17,888美元和8535美元。由公共资助的医疗保险计划资助了56%的患者；25%有私人保险，19%没有保险。53%的出院发生在371家收治火器相关损伤患者的医院中的13家。
与火器相关的暴力是年轻城市黑人男性住院的主要原因，对公共资助的医疗保健造成了重大成本。对个别医院的影响极不均衡。虽然医院出院数据可用于基于人群的火器相关创伤监测，但仍需要改进对这些损伤的地方、州和国家监测。
