Hospitalizations and healthcare costs associated with serious, non-lethal firearm-related violence and injuries in the United States, 1998-2011

Objective:To describe the prevalence,trends,correlates,and short-term outcomes of inpa-tient hospitalizations for firearm-related injuries(FRIs)in the United States between 1998 and 2011.Methods:We conducted a retrospective,cross-sectional analysis of inpatient hospitalizations using data from the Nationwide Inpatient Sample.In addition to generating national prevalence estimates,we used survey logistic regression to calculate odds ratios(ORs)and 95%confidence intervals(CIs)for the association between FRIs and patient/hospital-level characteristics.Tempo-ral trends were estimated and characterized using joinpoint regression.Results:There were 10.5 FRIs(95%CI:9.2-11.8)per 10,000 non-maternal/neonatal inpatient hospitalizations,with assault accounting for 60.1%of FRIs,followed by unintentional/accidental(23.0%)and intentional/self-inflicted FRIs(8.2%).The highest odds of FRIs,particularly FRIs associated with an assault,was observed among patients 18-24 years of age,patients 14-17 years of age,patients with no insurance/self-pay,and non-Hispanic blacks.The mean inpatient length of stay for FRIs was 6.9 days;however,4.7%of patients remained in the hospital over 24 days and 1 in 12 patients(8.2%)died before discharge.The mean cost of an inpatient hospitalization for a FRI was$22,149,which was estimated to be$679 million annually;approximately two-thirds of the annual cost(64.7%)was for assault($439 million).Conclusion:FRIs are a preventable public health issue which disproportionately impacts younger generations,while imposing significant economic and societal burdens,even in the ab-sence of fatalities.Prevention of FRIs should be considered a priority in this era of healthcare cost containment.