Miller T R, Cohen M A
National Public Services Research Institute, Landover, MD 20785, USA.
Accid Anal Prev. 1997 May;29(3):329-41. doi: 10.1016/s0001-4575(97)00007-9.
This article estimates the costs of U.S. gunshot and cut/stab wound by intent. It also compares U.S. to Canadian gunshot experience. Incidence data are from published sources, the National Hospital Ambulatory Medical Care Survey (NHAMCS), and cause-coded emergency department discharge and hospital discharge data systems. Medical care payments and lost earnings per case come from National Crime Survey data, a literature review, and weighting of costs by diagnosis from Databook on Nonfatal Injury-Incidence. Costs, and Consequences by Miller et al. (The Urban Institute Press, Washington, DC. 1995) with the diagnosis distribution of penetrating injuries from the discharge data systems. Quality of life losses are estimated primarily from jury awards to penetrating injury victims. In 1992, gunshots killed 37,776 Americans; cut/stab wounds killed 4095. Another 134,000 gunshot survivors and 3,100,000 cut/stab wound survivors received medical treatment. Annually, gunshot wounds cost an estimated U.S. $126 billion. Cut/stab wounds cost another U.S. $51 billion. The gunshot and cut/stab totals include U.S. $40 billion and U.S. $13 billion respectively in medical, public services, and work-loss costs. Across medically treated cases, costs average U.S. $154,000 per gunshot survivor and U.S. $12,000 per cut/stab survivor. Gunshot wounds are more than three times as common in the U.S. than in Canada, which has strict handgun control. With the same quality of life loss per victim, gunshot costs per capita are an estimated U.S. $495 in the U.S. vs U.S. $180 in Canada. Per gun, however, the costs are higher in Canada, Gunshot wound rates rise linearly with gun ownership.
本文按意图估算了美国枪伤和切割/刺伤的成本。它还将美国与加拿大的枪击经历进行了比较。发病率数据来自已发表的资料、国家医院门诊医疗调查(NHAMCS)以及病因编码的急诊科出院和医院出院数据系统。每个病例的医疗费用支付和收入损失来自国家犯罪调查数据、文献综述以及根据《非致命伤害发病率手册》中的诊断对成本进行的加权。成本和后果由米勒等人(城市研究所出版社,华盛顿特区,1995年)提供,并结合出院数据系统中穿透伤的诊断分布。生活质量损失主要根据陪审团对穿透伤受害者的赔偿来估算。1992年,枪伤导致37776名美国人死亡;切割/刺伤导致4095人死亡。另外,134000名枪伤幸存者和3100000名切割/刺伤幸存者接受了治疗。每年,枪伤估计花费美国1260亿美元。切割/刺伤再花费510亿美元。枪伤和切割/刺伤的总计费用分别包括400亿美元和130亿美元的医疗、公共服务和工作损失成本。在接受治疗的病例中,每名枪伤幸存者的平均成本为154000美元,每名切割/刺伤幸存者的平均成本为12000美元。在美国,枪伤的发生率是加拿大的三倍多,而加拿大有严格的手枪管制。在每个受害者生活质量损失相同的情况下,美国人均枪伤成本估计为495美元,而加拿大为180美元。然而,按每支枪计算,加拿大的成本更高。枪伤发生率与枪支拥有量呈线性上升。