Gunshot wound victims may prove an opportunity for hospitals

The United States lives to some degree under the specter of the gun, and by extension so do its medical providers. It is a sobering fact but also one that could mean an opportunity for hospitals.

There are hundreds of emergency physicians and surgeons in Los Angeles and New York alone who cut their teeth on saving and trying to save gunshot victims during the 1980s when the murder rates were five times what they are today. And while the murder rate has dipped dramatically, guns remain all over the place and the price tag for treating their victims is sky high.

A new report by the Urban Institute estimates that the cost of treating gunshot wounds in hospitals was about $669.2 million in 2010. It focused on the direct hospital costs in six states--Arizona, California, Maryland, New Jersey, North Carolina and Wisconsin. All had above-average rates for robberies committed by a gun. Arizona and North Carolina also had above-average rates for aggravated assault with guns.

Hospitals in those six states spent $136.8 million treating those victims, including $87.4 million in California alone. And on average, more than 78 percent of those victims either were insured by Medicaid or had no coverage at all.

Where is the opportunity for hospitals? In providing those always hard-to-define community benefits.

Gun violence is concentrated within specific demographic groups. Males between the ages of 15 and 24 make up between 38 percent and 48 percent of the victims who wind up using a hospital. Young African-American males are anywhere from 1.7 to 7.2 times more likely to wind up in a hospital with a gunshot wound than the next demographic group, Latino males.

In Maryland, an African-American male is more than 40 times more likely to be treated for a gunshot wound in a hospital that a white male. In Wisconsin, black males are nearly 80 times more likely to be treated in a hospital for gunshot wound than a white male. The disparities are not quite as great in the other states, but remain stark. And there are also great disparities between rates of treated gunshot wounds for African-American and white females.

Hospitals could use Census data to create outreach programs to try and reduce the number of guns in specific communities in their service area.

On the face of it, many hospital executives might think this is a politically fraught time to try and reduce gun ownership. The National Rifle Association (NRA) blocks the most rudimentary legislation even in the wake of horrifying incidents of mass shootings. But the demographics of legal gun ownership do not match those who wind up getting shot. Gun ownership levels among whites are 33 percent, nearly double the 18 percent rate among non-whites.

Buybacks using $100 or $200 gift cards for groceries or electronics have been able to get thousands of guns off the streets of Los Angeles for a relatively small cost. Arizona and Maryland also held buyback programs--one in Baltimore is among the oldest in the country. However, NRA lobbying required that guns purchased at any government-sponsored events in Arizona be resold to gun dealers.

Nevertheless, hospital outreach on this issue remains a great way to reduce violence, help surrounding communities and cut the costs of providing care. And it can likely be done in a manner that would avoid potential political blowback.--Ron(@FierceHealth)

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