Abstract
Little is known about the healthcare and economic burdens of non-fatal firearm injuries for children/youth beyond the initial admission. This study sought to estimate healthcare utilization and total direct healthcare costs of non-fatal powdered and non-powdered (air gun) firearm injuries 1-year post-injury. Using administrative data from 2003 to 2018 on all children/youth 0–24 years old in Ontario, Canada, a matched 1:2 cohort study was conducted to compare children/youth who experienced powdered and non-powdered firearm injuries with those who did not. Mean and median number of healthcare encounters and costs, and respective 95% confidence intervals (CIs) and interquartile ranges (IQRs), were estimated for both weapon type groups and controls and by intent. Children/youth who experienced a powdered and non-powdered firearm injury had a higher number of healthcare encounters and costs per year than those who did not. Mean 1-year costs for those with powdered and non-powdered firearm injuries were $8825 ($8007–$9643) and $2349 ($2118–$2578), respectively, versus $812 ($567–$1058) and $753 ($594–$911), respectively, for those without. Mean 1-year costs were highest for handgun injuries ($12,875 [95% CI $9941–$15,808]), and for intentional assault-related ($13,498 [$11,843–$15,153]; $3287 [$2213–$4362]), and intentional self-injuries ($14,773 [$6893–$22,652]; $6005 [$2193–$9817]) for both powdered and non-powdered firearm injuries, respectively. Conclusion: Firearm injuries have substantial healthcare and economic burdens beyond the initial injury-related admission; this should be accounted for when examining the overall impact of firearm injuries.What is Known:• Child/youth firearm injuries have significant health and economic burdens.• However, existing work has mainly examined healthcare utilization and costs of initial admissions and/or have been limited to single-center studies and no studies have provide cost estimates by weapon type and intent.What is New:• Children/youth who suffered powdered firearm injuries had higher mean healthcare utilization and costs than those with non-powdered firearm injuries as well as comparable healthy children/youth.• Mean 1-year costs were highest for handgun injuries ($12,875), and for intentional assault-related ($13,498; $3287), and intentional self-injuries ($14,773; $6005) for powdered and non-powdered firearm injuries, respectively.
Highlights
Firearm injuries remain a major public health concern in high-income countries, such as Canada and the United States (US)
Firearm injuries have substantial healthcare and economic burdens beyond the initial injury-related admission; this should be accounted for when examining the overall impact of firearm injuries
Mean 1-year costs were highest for handgun injuries ($12,875), and for intentional assault-related ($13,498; $3287), and intentional selfinjuries ($14,773; $6005) for powdered and non-powdered firearm injuries, respectively
Summary
Firearm injuries remain a major public health concern in high-income countries, such as Canada and the United States (US). Intentional and unintentional injuries, including firearm injuries, are among the top causes of death for young people in Canada [2], while. European Journal of Pediatrics (2022) 181:2329–2342 in the US unintentional injuries have been reported as the top cause of death among children and youth [3]. In the US, firearm injuries resulted in $17 billion (2010 USD) in annual healthcare costs across all ages [5]. Average annual costs for the initial admission alone have been reported to be around $622–$735 million (2013 USD) [6, 7]. Little is known about the healthcare and economic burdens of non-fatal powdered and non-powdered (air gun) firearm injuries for children and youth beyond the initial admission, which are likely to occur at least 1-year post-injury, or at a population-based level, as many studies have been limited to single-center studies [8–10]. Cost-of-illness studies provide useful information for decision-makers as they translate the adverse effects of diseases into dollars and help quantify the size of the problem
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