PROVIDENCE, R.I. [Brown University] — How much does a treating a gunshot injury cost? New research says the answer is $8.2 million for those with an emergency visit only — and a staggering $41.2 million for injuries that require hospital admission.
The incidence of firearm injury and death in the United States is increasing, and though the impact of these injuries on health care providers is estimated to be high, research to date has not investigated data on pre- and post-injury health care visits and related costs.
To close that gap, a team led by Dr. Megan Ranney — an emergency physician and associate professor of emergency medicine and health services, policy and practice at Brown University — conducted a study that found that in the six months after surviving a firearm injury, patient health care costs increased three to 20 times, depending on whether the person was hospitalized, compared to the six months prior to injury.
“When you look at the reasons to prevent firearm injury, you want to do so because it hurts people,” said Ranney, who is also chief research officer for the American Foundation for Firearm Injury Reduction in Medicine. “You want to prevent firearm injury because of the emotional aftermath. You want to prevent firearm injury because it’s wrong to let people get hurt. But for some people, they may want to prevent firearm injury because it’s expensive.”
The findings were published in the Sept. 29 issue of the journal Annals of Internal Medicine.
Using insurance claim data from the five states — Texas, Illinois, Oklahoma, New Mexico and Montana — in which Blue Cross Blue Shield (BCBS) operates under the umbrella of the Health Care Service Corporation (HCSC), the team analyzed changes in actually health care costs and utilization rates in the six months following a firearm injury, relative to the six months prior to it.
Patients must have been continuously covered by a BCBS insurance plan for at least 12 months before and after a firearm injury sustained at any time from 2015 to 2017.
“This view outside of the usual (and still very important) public health perspective allows us to see not just the uninsured and Medicaid population, but individuals who have group coverage,” said Leanne Metcalfe, affiliate faculty at the University of Texas Health Science Center and a study co-author. “This could be your co-worker, your boss, someone’s spouse or someone’s child.”
Overall, 2,019 members (representing 19,440 claims) had an index emergency department (ED) or hospital visit for a firearm injury during the study period. In comparing the six-month periods before and after the initial firearm injury visit, the number of insurance claims increased 187% for patients discharged from the ED and 608% for those hospitalized. Mental health claims for the same group during the same periods increased 106% and 319%, respectively.
Translated into dollars, that means that the total initial health care costs for the ED visit for a firearm injury discharged from the ED were approximately $8.2 million, or $5,686 per member on average. Total health care costs for hospital admission, inclusive of an ED visit, for a firearm injury requiring hospitalization were $41.2 million, or $70,644 per member on average. Per member (ED) costs increased 346%, from $3,984 to $17,806. For those hospitalized, their costs went up a staggering 2,138%, from $4,118 to $92,151.