Abstract：
Firearm injury poses a significant public health burden in the United States.
The purpose of this systematic review was to provide a comprehensive accounting of the medical costs of firearm injuries in the United States.
A systematic literature review was conducted to identify studies published between January 1, 2000 and July 13, 2022 that reported medical costs of firearm injuries. A search of Embase, PubMed, and the Cochrane Library databases was performed by a medical librarian. The National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to evaluate for risk of bias. Health care-related charges and costs per firearm injury were presented and trends were identified.
Sixty-four studies were included in the analysis. Study sample sizes ranged from 18 to 868,483 patients. Reported costs per injury ranged from $261 to $529,609. The median cost reported was $27,820 (interquartile range [IQR] $15,133-$40,124) and median charge reported was $53,832 (IQR $38,890-$98,632). Studies that divided initial hospitalization costs and follow-up medical costs identified that initial hospitalization accounts for about 60% of total costs.
We found a significant volume of literature about the medical costs of firearm injury, which identified a highly heterogeneous cost burden. A significant amount of cost burden occurs after the index hospitalization, which is the only cost reported in most studies. Limitations of this study include reporting bias that favors hospitalized patients as well as a large focus on hospital charges as measurements of cost identified in the literature.
The purpose of this systematic review was to provide a comprehensive accounting of the medical costs of firearm injuries in the United States.
A systematic literature review was conducted to identify studies published between January 1, 2000 and July 13, 2022 that reported medical costs of firearm injuries. A search of Embase, PubMed, and the Cochrane Library databases was performed by a medical librarian. The National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to evaluate for risk of bias. Health care-related charges and costs per firearm injury were presented and trends were identified.
Sixty-four studies were included in the analysis. Study sample sizes ranged from 18 to 868,483 patients. Reported costs per injury ranged from $261 to $529,609. The median cost reported was $27,820 (interquartile range [IQR] $15,133-$40,124) and median charge reported was $53,832 (IQR $38,890-$98,632). Studies that divided initial hospitalization costs and follow-up medical costs identified that initial hospitalization accounts for about 60% of total costs.
We found a significant volume of literature about the medical costs of firearm injury, which identified a highly heterogeneous cost burden. A significant amount of cost burden occurs after the index hospitalization, which is the only cost reported in most studies. Limitations of this study include reporting bias that favors hospitalized patients as well as a large focus on hospital charges as measurements of cost identified in the literature.
摘要：
背景：枪支伤害在美国造成了重大的公共卫生负担。
目的：本系统评价的目的是对美国枪支伤害的医疗费用进行全面的核算。
方法：进行了系统的文献综述，以确定2000年1月1日至2022年7月13日之间发表的报告枪支伤害医疗费用的研究。搜索Embase,PubMed,Cochrane图书馆的数据库是由一名医学图书馆员完成的。美国国立卫生研究院用于观察队列和横断面研究的质量评估工具用于评估偏倚风险。介绍了与医疗保健有关的费用和每次枪支伤害的费用，并确定了趋势。
结果：64项研究纳入分析。研究样本量为18至868,483名患者。每次受伤的报告费用从261美元到529609美元不等。报告的费用中位数为27,820美元（四分位数范围[IQR]$15,133-$40,124），报告的费用中位数为$53,832（IQR$38,890-$98,632）。划分初始住院费用和后续医疗费用的研究表明，初始住院约占总费用的60％。
结论：我们发现了大量关于枪支伤害医疗费用的文献，这确定了一个高度异质的成本负担。指数住院后发生大量的费用负担，这是大多数研究报告的唯一成本。这项研究的局限性包括报告偏爱住院患者的偏见，以及大量关注医院费用作为文献中确定的成本衡量标准。
目的：本系统评价的目的是对美国枪支伤害的医疗费用进行全面的核算。
方法：进行了系统的文献综述，以确定2000年1月1日至2022年7月13日之间发表的报告枪支伤害医疗费用的研究。搜索Embase,PubMed,Cochrane图书馆的数据库是由一名医学图书馆员完成的。美国国立卫生研究院用于观察队列和横断面研究的质量评估工具用于评估偏倚风险。介绍了与医疗保健有关的费用和每次枪支伤害的费用，并确定了趋势。
结果：64项研究纳入分析。研究样本量为18至868,483名患者。每次受伤的报告费用从261美元到529609美元不等。报告的费用中位数为27,820美元（四分位数范围[IQR]$15,133-$40,124），报告的费用中位数为$53,832（IQR$38,890-$98,632）。划分初始住院费用和后续医疗费用的研究表明，初始住院约占总费用的60％。
结论：我们发现了大量关于枪支伤害医疗费用的文献，这确定了一个高度异质的成本负担。指数住院后发生大量的费用负担，这是大多数研究报告的唯一成本。这项研究的局限性包括报告偏爱住院患者的偏见，以及大量关注医院费用作为文献中确定的成本衡量标准。
