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Cook PJ, Lawrence BA, Ludwig J, Miller TR. The Medical Costs of Gunshot Injuries in the United States. JAMA. 1999;282(5):447–454. doi:10.1001/jama.282.5.447
Author Affiliations: Sanford Institute of Public Policy, Duke University, Durham, NC (Dr Cook); National Public Services Research Institute, Landoven, Md (Drs Lawrence and Miller); and Georgetown Public Policy Institute, Georgetown University, Washington, DC (Dr Ludwig).
Context The cost of treating gunshot injuries imposes a financial burden on
society. Estimates of such costs are relevant to evaluation of gun violence
reduction programs and may help guide reimbursement policies.
Objectives To develop reliable US estimates of the medical costs of treating gunshot
injuries and to present national estimates for the sources of payment for
treating these injuries.
Design and Setting Cost analysis using E-coded discharge data from hospitals in Maryland
for 1994-1995 and New York for 1994 and from emergency departments in South
Carolina for 1997. Other sources of data included the National Electronic
Injury Surveillance System for 1994 incidence of nonfatal gun injuries, the
National Spinal Cord Injury Statistical Center database for 1988-1992 estimates
of lifetime medical costs of gun injuries, and the 1994 Vital Statistics census
for incidence of fatal gun injuries.
Main Outcome Measures Estimated national acute-care and follow-up treatment costs and payment
sources for gunshot injuries.
Results At a mean medical cost per injury of about $17,000, the 134,445 (95%
confidence interval [CI], 109,465-159,425) gunshot injuries in the United
States in 1994 produced $2.3 billion (95% CI, $2.1 billion–$2.5 billion)
in lifetime medical costs (in 1994 dollars, using a 3% real discount rate),
of which $1.1 billion (49%) was paid by US taxpayers. Gunshot injuries due
to assaults accounted for 74% of total costs.
Conclusions Gunshot injury costs represent a substantial burden to the medical care
system. Nearly half this cost is borne by US taxpayers.
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