Non-fatal firearm injuries: Utilization and expenditures for children pre- and post-injury.

OBJECTIVE Firearm injuries are one of the leading preventable causes of morbidity and mortality among children. Limited information exists about the impact of non-fatal firearm injuries on utilization and expenditures. Our objective was to compare healthcare encounters and expenditures one year before and one year following a non-fatal firearm injury. METHODS Retrospective cohort study of children 0-18 years with ICD-9/ICD-10 diagnosis codes for firearm injury in the emergency department or inpatient setting from 2010-2016 in the Medicaid MarketScan claims database. Outcomes included: 1) difference in healthcare encounters for one year before and one year after injury; 2) difference in healthcare expenditures; 3) difference in complex chronic disease status. Descriptive statistics characterized patient demographics and healthcare utilization. Health expenditures were evaluated with Wilcoxon Sign Rank Tests. RESULTS Among 3,296 children, there were 47,660 healthcare encounters before the injury and 61,660 after. Concomitantly, there was an overall increase of $18.5 million in health expenditures ($5,612 per patient). There was a 40% increase in children qualifying for complex chronic condition status after firearm injury. CONCLUSIONS Children who experience non-fatal firearm injury have increased number of healthcare encounters, chronic disease classification, and healthcare expenditures in the year following the injury. Prevention of firearm injuries in this vulnerable age group may result in considerable reductions in morbidity and healthcare costs.