3192.0: Monday, November 13, 2000 - 4:30 PM

Abstract #3385

Assessing the long term costs of non-fatal gun-related injuries: An innovative approach

Janny Dwyer Brust, MPH1, Angeline Carlson, PhD2, and Sara J. Seifert, MPH1. (1) Community Investment, Allina Health System, 2800 Chicago Avenue South, Suite 330, Minneapolis, MN 55407, (612) 863-5173, brust@allina.com, (2) Data Intelligence, P.O. Box 44993, Eden Prairie, MN 55344

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.

The 128th Annual Meeting of APHA