Risks, costs, and the expected complication of re-injury.

Background: The purpose of this study was to determine the characteristics of young victims of violence and the risk of rehospitalization due to intentional injury (recidivism) and to estimate the potential cost of these injuries.

Materials And Methods: Trauma admissions from January 1, 1991 to December 31, 1993, at San Francisco General Hospital of youths < 25 years old who were victims of gunshot wounds (GSWs), assault, and stab wounds were screened. Five hundred and fifty-two charts were reviewed after sampling every other chart. The cost of hospitalization was estimated from the Medicare charge-to-cost ratio.

Results: There were 87 (16%) persons who had a prior injury, of whom 82 (94%) had suffered their injury within the previous 5 years. The predominate mechanism 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 major risk factor and potential predictor for re-injury. Firearms are a major mechanism of intentional injury among youths and a major determinate of death. With the estimated cost of $2,562,363.72 per year for all youths at our hospital, intentional injury is a major health care issue for youths and hospitals.