TY  - JOUR
PY  - 2021//
TI  - Comparison of cost and resource utilization between firearm injuries and motor vehicle collisions at pediatric hospitals
JO  - Academic emergency medicine
A1  - Fraser Doh, Kiesha
A1  - Sheline, Erica
A1  - Wetzel, Martha
A1  - Simon, Harold K.
A1  - Morris, Claudia R.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND/OBJECTIVES: Firearm injuries are converging with motor vehicle collisions (MVC) as the number one cause of death for children in the United States. Thus we examine differences in hospital cost and hospital resource utilization between motor vehicle and firearm injury. <br><br>METHODS: This retrospective, cross-sectional study compares hospital costs and resource utilization of motor vehicle and firearm injured children aged 0-19 years of age over a 5-year time frame (January 1, 2013-December 31, 2017) in 35 freestanding children's hospitals that submitted data to the Pediatric Health Information System (PHIS). The primary outcome was hospital-adjusted comparative cost per patient presentation. Generalized linear mixed models were used to quantify the relationship between the type of injury and each outcome, adjusting for patient characteristics and hospital. <br><br>RESULTS: There were 89,133 emergency department (ED) visits attributed to MVC and 3,235 for firearm injury. Of the youths who presented for firearm injury, 49% were hospitalized versus 14% of youths presenting with MVC (aOR: 6.6, 95% CI 6.1 - 7.2). Youths with firearm injury were more likely to be admitted to an intensive care unit (aOR: 6.7, 95% CI 5.9 - 7.7) and had longer lengths of stays (aOR:2.2, 95% CI 1.9 - 2.6) compared to their MVC counterparts. Children admitted for firearm injury had more imaging and ED-return visits, along with subsequent inpatient admission within three days (aOR: 3.4, 95% CI 2.1 - 5.5) and one year (OR:2.5, 95% CI 2.1 - 2.9). The mean relative per-patient costs were nearly 5-fold higher for the firearm injured group. <br><br>CONCLUSIONS: Hospital costs and markers of resource utilization were higher for youths with firearm injury compared to MVC. High medical resource utilization is one of several important reasons to advocate for a comparable national focus and funding on firearm-related injury prevention.<p />  <p>Language: en</p>
LA  - en
SN  - 1069-6563
UR  - http://dx.doi.org/10.1111/acem.14234
ID  - ref1
ER  -