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Trends in healthcare utilisation for firearm-related injuries among a cohort of publicly insured children in Ohio
  1. Charitha Gowda1,
  2. Rose Y Hardy2,
  3. Steven Traylor3,
  4. Gilbert C Liu1
  1. 1 Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
  2. 2 Center for Innovation in Pediatric Practice, Nationwide Children's Hospital, Columbus, Ohio, USA
  3. 3 Partners For Kids, Columbus, Ohio, USA
  1. Correspondence to Dr Charitha Gowda, Pediatrics, The Ohio State University College of Medicine, Columbus, OH 43205, USA; charitha.gowda{at}


Objective To examine healthcare utilisation for all firearm-related injuries among publicly insured children.

Methods A retrospective analysis of firearm injury medical claims among paediatric (<21 years) Medicaid beneficiaries in Ohio from 2010 to 2018. Factors associated with unintentional and intentional firearm injury were explored using multivariable logistic regression. Average annual patient healthcare costs were determined in 2019 US$.

Results There were 1061 firearm injury-related claims (853 (80%) unintentional; 154 (15%) intentional; 54 (5%) unknown) occurring in 663 children over 2 736 517 available person-years. From 2010 to 2018, yearly total firearm claims rose from 19.7 to 31.3 per 100 000 persons (p=0.033). Urban children experienced a non-significant increase in firearm claims rate over time (26.1 vs 35.0/100 000; p=0.066) while the claims rate nearly tripled among those in rural areas (8.4 vs 24.0/100 000; p=0.012). Younger age, females and rural residence were associated with reduced odds of injury claims. The average annual costs for emergency department and inpatient visits, respectively, were $260 and $5735.

Conclusion Risk and type of firearm injury claims among low-income children in Ohio varies by age, sex and residence. Prevention programmes should be tailored based on these demographics.

  • health services
  • child health
  • injury

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  • Contributors CG, RYH and GCL conceptualised and designed the study, completed the data analyses, drafted the initial manuscript and reviewed and revised the manuscript. ST collected the data, carried out the initial analysis and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests The work described in this study was completed while all authors were employees of the accountable care organisation Partners For Kids (Columbus, Ohio).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.