The cost of treating serious abdominal firearm-related injuries in South Africa.
BACKGROUND
Firearms, the leading external cause of non-natural deaths in South Africa, claim approximately 15,000 lives annually. Up to 127,000 firearm-injured victims seek state health care assistance per annum. The fiscal burden of treating these injuries is not known.


METHODS
All serious abdominal firearm-related injuries (requiring admission to hospital and emergency surgery) presenting to a state hospital over a 6-month period were reviewed. A cost analysis using five variables was performed: operating theatre time, duration of hospital and high-care unit stay, pharmaceutical and blood products used, laboratory services used and diagnostic imaging studies performed.


RESULTS
Twenty-three patients with serious abdominal gunshot injuries were admitted, of whom 21 (91%) were treated at the hospital from admission until discharge. Each admission cost approximately US dollars 1,467. Hospital stay (47%) and operating theatre (30%) costs accounted for most of the total cost. Pharmaceuticals and blood products (20%), laboratory services (2%) and imaging studies (1%) contributed less than 25% to the total cost.


CONCLUSIONS
Serious abdominal gunshot injuries cost at least 13-fold more than the annual per capita South African government expenditure on health. This fiscal burden of approximately US dollars 2.9 million, almost 4% of the annual health budget, does not include the cost of treating other serious gunshot injuries. These findings highlight the need for successful violence prevention strategies in South African.
Allard
D
D
Department of Surgery, G F Jooste Hospital, Cape Town. denisallard@mweb.co.za
Burch
V C
VC
D000007:Abdominal Injuries / Q000191:economics* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003362:Cost-Benefit Analysis; D003906:Developing Countries; D004636:Emergency Service, Hospital / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D005389:Firearms / Q000706:statistics & numerical data; D017048:Health Care Costs; D017721:Hospital Costs; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D007902:Length of Stay / Q000191:economics; D008297:Male; D013019:South Africa / Q000453:epidemiology; D015996:Survival Rate; D014948:Wounds, Gunshot / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*