RISKS, COSTS, AND THE EXPECTED COMPLICATION OF RE-INJURY

BACKGROUND: The purpose of this study was to determine the characteris tics of young victims of violence and the risk of rehospitalization du e to intentional injury (recidivism) and to estimate the potential cos t of these injuries. MATERIALS AND METHODS: Trauma admissions from Jan uary 1, 1991 to December 31, 1993, at San Francisco General Hospital o f youths <25 years old who were victims of gunshot wounds (GSWs), assa ult, and stab wounds were screened. Five hundred and fifty-two charts were reviewed after sampling every other chart. The cost of hospitaliz ation was estimated from the Medicare charge-to-cost ratio. RESULTS: T here were 87 (16%) persons who had a prior injury, of whom 82 (94%) ha d suffered their injury within the previous 5 years. The predominate m echanism of injury was GSW (242, 44%). There were 38 deaths; 35 (92%) were by firearms. The estimated cost of hospitalization for 552 youths for 3 years was $3,843,545.58. CONCLUSIONS: Intentional injury is a m ajor risk factor and potential predictor for re-injury, Firearms are a major mechanism of intentional injury among youths and a major determ inate of death. With the estimated cost of $2,562,353.72 per year for all youths at our hospital, intentional injury is a major health care issue for youths and hospitals.