Article Text

Download PDFPDF

Hospitalizations and healthcare costs associated with serious, non-lethal firearm-related violence and injuries in the United States, 1998–2011
  1. Jason L. Salemi1,
  2. Vikas Jindal2,
  3. Roneé E. Wilson3,
  4. Mulubrhan F. Mogos4,
  5. Muktar H. Aliyu5 and
  6. Hamisu M. Salihu1
  1. 1.Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas, USA
  2. 2.Department of Occupational Health, Kaiser Permanente, Lancaster, California, USA
  3. 3.Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, Florida, USA
  4. 4.Department of Community Health Systems, School of Nursing, Indiana University, Indianapolis, Indiana, USA
  5. 5.Vanderbilt Institute for Global Health, Vanderbilt University,, Nashville, Tennesse, USA
  1. Corresponding Author: Jason L. Salemi, PhD, MPH Department of Family and Community Medicine 3701 Kirby Drive, Suite 600, Houston, TX 77098, USA Tel.: +713-798-4698 E-mail: Jason.Salemi{at}


Objective To describe the prevalence, trends, correlates, and short-term outcomes of inpatient hospitalizations for firearm-related injuries (FRIs) in the United States between 1998 and 2011.

Methods We conducted a retrospective, cross-sectional analysis of inpatient hospitalizations using data from the Nationwide Inpatient Sample. In addition to generating national prevalence estimates, we used survey logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between FRIs and patient/hospital-level characteristics. Temporal trends were estimated and characterized using joinpoint regression.

Results There were 10.5 FRIs (95% CI: 9.2–11.8) per 10,000 non-maternal/neonatal inpatient hospitalizations, with assault accounting for 60.1% of FRIs, followed by unintentional/accidental (23.0%) and intentional/self-inflicted FRIs (8.2%). The highest odds of FRIs, particularly FRIs associated with an assault, was observed among patients 18–24 years of age, patients 14–17 years of age, patients with no insurance/self-pay, and non-Hispanic blacks. The mean inpatient length of stay for FRIs was 6.9 days; however, 4.7% of patients remained in the hospital over 24 days and 1 in 12 patients (8.2%) died before discharge. The mean cost of an inpatient hospitalization for a FRI was $22,149, which was estimated to be $679 million annually; approximately two-thirds of the annual cost (64.7%) was for assault ($439 million).

Conclusions FRIs are a preventable public health issue which disproportionately impacts younger generations, while imposing significant economic and societal burdens, even in the absence of fatalities. Prevention of FRIs should be considered a priority in this era of healthcare cost containment.

  • Assault
  • cost
  • gunshot
  • firearms
  • hospitalization
  • intentional injury

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.