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Am J Public Health. 2017 May;107(5):770-774. doi: 10.2105/AJPH.2017.303684. Epub 2017 Mar 21.

Costs and Financial Burden of Initial Hospitalizations for Firearm Injuries in the United States, 2006-2014.

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Sarabeth A. Spitzer is a medical student at Stanford University School of Medicine, Stanford, CA. Kristan L. Staudenmayer, Lakshika Tennakoon, David A. Spain, and Thomas G. Weiser are with the Department of Surgery, Stanford University School of Medicine.



To quantify the inflation-adjusted costs associated with initial hospitalizations for firearm-related injuries in the United States.


We used the Healthcare Cost and Utilization Project Nationwide Inpatient Sample to identify patients admitted for firearm-related injuries from 2006 to 2014. We converted charges from hospitalization to costs, which we inflation-adjusted to 2014 dollars. We used survey weights to create national estimates.


Costs for the initial inpatient hospitalization totaled $6.61 billion. The largest proportion was for patients with governmental insurance coverage, totaling $2.70 billion (40.8%) and was divided between Medicaid ($2.30 billion) and Medicare ($0.40 billion). Self-pay individuals accounted for $1.56 billion (23.6%) in costs.


From 2006 to 2014, the cost of initial hospitalizations for firearm-related injuries averaged $734.6 million per year. Medicaid paid one third and self-pay patients one quarter of the financial burden. These figures substantially underestimate true health care costs. Public health implications. Firearm-related injuries are costly to the US health care system and are particularly burdensome to government insurance and the self-paying poor.

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