Assessing the costs of non-fatal firearm injuries has been hampered by limited e-coding by hospitals and emergency departments and by e-code protocol that assesses the initial encounter only. Through an innovative approach, an HMO's claims database was used to assess the costs of non-fatal gun shot injuries over a three-month period of time. The HMO has over 1 million members. Subjects were identified as gun shot victims through the use of e-codes, from 1/1/97-12/31/97. Sixty-three members were identified: 37 (59%) unintentional; 19 (30%) assaults; and 7(11%) unknown. There were no injuries due to legal intervention or suicide. Average age was 25.1 years (range 3-92 years). Initial treatment was ambulatory based for 17(27%); 28 (44%) were treated and released for emergency care; 18 (28%) received initial treatment including hospitalization. Average length of stay was 9.6 days. Total costs were $527,466. One individual had a cost of $278,000 or 49% of total. When removed, average length of stay for the remaining hospitalizations was 4.6 days (sd ± 3.0 days). Average costs varied: with ambulatory setting at $1,884; emergency department at $2,012; and hospitalization at $11,189. This study demonstrates that a claims database can be used to assess long-term costs of firearm injuries as well as other injuries. Data are proded on actual payments rather than charges and costs, which are less accurate; assesses total medical costs including pharmacy, out-of-pocket, and ambulatory care. The methodology, findings, strengths, limitations, and plans for further studies will be discussed.
Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to:describe the methodology of using claims data to assess the costs of non-fatal gun-related injuries; identify the strengths and limitations of this methodology; describe ways to apply this methodology to other injuries; describe the long term costs of gun-related injuries for persons seen in clinics, emergency departments and hospitals
Keywords: Firearms, Cost Issues
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: The claims data are from a midwestern HMO (Medica), however, this HMO will not be specifically identified
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: I'm employed by the health system that owns the data base used in this study.