Costs of gunshot and cut/stab wounds in the United States, with some Canadian comparisons

Abstract

This article estimates the costs of U.S. gunshot and cut/stab wounds by intent. It also compares U.S. to Canadian gunshot experience. Incidence data are from published sources, the National Hospital Ambulatory Medical Care Survey (NHAMCS), and cause-coded emergency department discharge and hospital discharge data systems. Medical care payments and lost earnings per case come from National Crime Survey data, a literature review, and weighting of costs by diagnosis from Databook on Nonfatal Injury—Incidence, Costs, and Consequences by Miller et al. (The Urban Institute Press, Washington, DC, 1995) with the diagnosis distribution of penetrating injuries from the discharge data systems. Quality of life losses are estimated primarily from jury awards to penetrating injury victims. In 1992, gunshots killed 37,776 Americans; cut/stab wounds killed 4095. Another 134,000 gunshot survivors and 3,100,000 cut/stab wound survivors received medical treatment. Annually, gunshot wounds cost an estimated U.S.$126 billion. Cut/stab wounds cost another U.S.$51 billion. The gunshot and cut/stab totals include U.S.$40 billion and U.S.$13 billion respectively in medical, public services, and work-loss costs. Across medically treated cases, costs average U.S.$154,000 per gunshot survivor and U.S.$12,000 per cut/stab survivor. Gunshot wounds are more than three times as common in the U.S. than in Canada, which has strict handgun control. With the same quality of life loss per victim, gunshot costs per capita are an estimated U.S.$495 in the U.S. vs U.S.$180 in Canada. Per gun, however, the costs are higher in Canada. Gunshot wound rates rise linearly with gun ownership.