"Despite the magnitude of firearm-related injuries and considerable variations in these injuries over time, there is currently no nationwide surveillance system for firearm-related injuries," says study author Jeffrey H. Coben, M.D., of the Allegheny-Singer Research Institute's Center for Violence and Injury Control at Allegheny General Hospital in Pittsburgh, Pa.
"Hospital discharge data can help monitor firearm injury trends over time and provide needed data to examine policy issues, such as the effects of the Brady Law and concealed weapons legislation," he adds. Information on gun-related deaths is available from the Vital Statistics deaths census, and the Centers for Disease Control and Prevention is developing the National Violent Death Reporting System, but information on nonfatal injuries is needed to see the whole picture of guns' effects on society, according to the study.
Coben was affiliated with the Agency for Healthcare Research and Quality at the U.S. Department of Health and Human Services in Rockville, Md., when he conducted this research. He and study co-author Claudia A. Steiner, M.D., M.P.H., also of AHRQ, examined 1997 patient discharge data from more than 1,000 hospitals in 22 states using a database called the Nationwide Inpatient Sample, which is part of a federal data collection effort.
Their findings, which were in line with previous gunshot injury estimates, suggest a grim picture: Gunshots wounded more than 35,000 individuals, mostly males (86 percent), nationwide in 1997. Treatment of these injuries cost over $802 million, and nearly 30 percent of the wounded were uninsured.
"Despite recent declines in the number of firearm-related deaths and injuries, these findings illustrated the substantial health, disability and economic impact of these injuries," Coben says. "These findings suggest NIS is a useful source of national data on firearm-related hospitalizations," he adds. The study results are published in the January issue of the American Journal of Preventive Medicine.
The NIS provides information on factors such as length of stay, procedures, outcomes and costs that the National Electronic Injury Surveillance System, another database used to measure gunshot injuries, doesn't. "NIS may serve as the gold standard for inpatient data," Coben says.
The NIS revealed the average length of stay for 1997 gunshot injuries was six days, compared with an average of 4.9 days for all medical conditions. The average treatment cost per assault case was approximately $24,000.
Coben and Steiner note that the number of states providing data to the NIS system continues to increase, and they recommend that the NIS eventually be incorporated into a comprehensive national system. "This ongoing national data system may provide useful data for future injury surveillance and research," Coben concludes.
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