Comparison of the costs of acute treatment for gunshot and stab wounds: further evidence of the need for firearms control.
Gun control is proposed primarily to decrease the incidence of injury and death from gunshot wounds (GSWs). We hypothesize that decreasing the number of GSWs will also produce significant economic savings, even if personal violence were to continue at the same rate, maintaining the same overall incidence of penetrating trauma. We analyzed charges and reimbursements for the treatment for all patients with GSWs (n = 1116) and stab wounds (SWs) (n = 1529) admitted to a level I trauma center from 1986 through 1992. Mean and median charges were higher for GSWs ($14,541; $7,541) than for SWs ($6,446; $4,249) (p < 0.05). There was a 12% per year increase in the annual number of GSWs (p = 0.001), leading to a disproportionate increase in the annual total charges for GSWs (p = 0.013), compared with SWs. Public expenditures, including bad debt and government reimbursement, increased for GSWs (p = 0.019) but not SWs. Thus, if all patients with GSWs instead suffered SWs, there would be an annual savings of $1,290,000 overall and of $981,000 of public funds from this institution alone. Treatment costs for GSWs are higher than those for SWs and are rising more rapidly, with an increasing amount of public funds going to meet these costs. Considerable savings to society would accrue from any effort that decreased firearm injuries, even if the same level of violence persisted using other weapons.
Mock
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C
Department of Surgery, University of Washington, Seattle.
Pilcher
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S
Maier
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R
D017281:Cost of Illness; D005251:Fees, Medical; D005389:Firearms / Q000331:legislation & jurisprudence*; D017722:Hospital Charges; D006801:Humans; D012189:Retrospective Studies; D012926:Social Control, Formal; D016896:Treatment Outcome; D014481:United States; D014948:Wounds, Gunshot / Q000191:economics*; D014951:Wounds, Stab / Q000191:economics*