American journal of preventive medicine · 2026
Hospital Admission Status and Healthcare Services Among Adults With Firearm Injury: A Retrospective Cohort Study.
СтатьяНазвание и аннотация: Перевод в очереди
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Geier Timothy J, Timmer-Murillo Sydney C, Flynn-O'Brien Katherine T, deRoon-Cassini Terri A
Аннотация
INTRODUCTION: Nonfatal firearm injuries are increasing nationwide. Survivors often experience physical disability, chronic pain, and psychological trauma requiring targeted interventions. Services available in the emergency department may differ from those provided upon admission. This study explored differences in services and healthcare utilization between patients with nonfatal firearm injuries admitted to hospital versus discharged from the emergency department.
METHODS: A retrospective cohort study of adults aged ≥18 years with nonfatal firearm injuries was conducted at a Level 1 Trauma Center (2016-2020). Patients admitted to the hospital were compared with those discharged from the emergency department. Outcomes included hospital-based services use (psychology consultation, hospital-based violence intervention program referral) and 90-day healthcare utilization (outpatient visits, emergency department revisits, readmissions). Multivariable logistic regression examined factors associated with admission and hospital-based violence intervention program referral among eligible patients. Postdischarge utilization was analyzed over a fixed 90-day window using bivariate comparisons.
RESULTS: Among 1,522 patients, 449 (29.5%) were discharged from the emergency department. Admitted patients had greater injury severity (mean=13.09 vs 5.07, p<0.0001) and received more psychology consultations (28.8% vs 0.7%, p<0.0001) and higher hospital-based violence intervention program referral rates when eligible (67.7% vs 55.0%, p=0.0217). Among hospital-based violence intervention program-eligible patients, racial/ethnic minority status was associated with higher odds of referral (AOR=3.127, p=0.0056). At 90 days, admitted patients had greater healthcare utilization, including follow-up appointments (mean=6.45 vs 1.89, p<0.0001), emergency department visits (mean=0.37 vs 0.20, p=0.0001), readmissions (mean=0.28 vs 0.07, p<0.0001), and behavioral health visits (3.45% vs 0.89%, p=0.00549).
CONCLUSIONS: Admission status was linked to greater access to psychology services and hospital-based violence intervention program referral. Emergency department-discharged patients rarely received these services, highlighting missed opportunities for early intervention. Standardized emergency department-based protocols may improve access to psychological support and violence prevention services.
METHODS: A retrospective cohort study of adults aged ≥18 years with nonfatal firearm injuries was conducted at a Level 1 Trauma Center (2016-2020). Patients admitted to the hospital were compared with those discharged from the emergency department. Outcomes included hospital-based services use (psychology consultation, hospital-based violence intervention program referral) and 90-day healthcare utilization (outpatient visits, emergency department revisits, readmissions). Multivariable logistic regression examined factors associated with admission and hospital-based violence intervention program referral among eligible patients. Postdischarge utilization was analyzed over a fixed 90-day window using bivariate comparisons.
RESULTS: Among 1,522 patients, 449 (29.5%) were discharged from the emergency department. Admitted patients had greater injury severity (mean=13.09 vs 5.07, p<0.0001) and received more psychology consultations (28.8% vs 0.7%, p<0.0001) and higher hospital-based violence intervention program referral rates when eligible (67.7% vs 55.0%, p=0.0217). Among hospital-based violence intervention program-eligible patients, racial/ethnic minority status was associated with higher odds of referral (AOR=3.127, p=0.0056). At 90 days, admitted patients had greater healthcare utilization, including follow-up appointments (mean=6.45 vs 1.89, p<0.0001), emergency department visits (mean=0.37 vs 0.20, p=0.0001), readmissions (mean=0.28 vs 0.07, p<0.0001), and behavioral health visits (3.45% vs 0.89%, p=0.00549).
CONCLUSIONS: Admission status was linked to greater access to psychology services and hospital-based violence intervention program referral. Emergency department-discharged patients rarely received these services, highlighting missed opportunities for early intervention. Standardized emergency department-based protocols may improve access to psychological support and violence prevention services.