• T R Miller.
• National Public Services Research Institute, Landover, MD 20785, USA.
• CMAJ. 1995 Nov 1;153(9):1261-8.

ObjectiveTo estimate the costs (in 1993 dollars) associated with gunshot wounds in Canada in 1991.DesignCost analysis using separate estimates of gunshot incidence rates and costs per incident for victims who died, those who survived and were admitted to hospital and those who survived and were treated and released from emergency departments. Estimates were based on costs for medical care, mental health care, public services (i.e., police investigation), productivity losses, funeral expenses, and individual and family pain, suffering and lost quality of life.SettingCanada.Outcome MeasuresCosts per case, costs by type of incident (e.g., assault, suicide or unintentional shooting) and costs per capita.ResultsThe total estimated cost associated with gunshot wounds was $6.6 billion. Of this, approximately $63 million was spent on medical and mental health care and $10 million on public services. Productivity losses exceeded $1.5 billion. The remaining cost represented the value attributed to pain, suffering and lost quality of life. Suicides and attempted suicides accounted for the bulk of the costs ($4.7 billion); homicides and assaults were the next most costly ($1.1 billion). The cost per survivor admitted to hospital was approximately $300,000; this amount included just over $29,000 for medical and mental health care.ConclusionCosts associated with gunshot wounds were $235 per capita in Canada in 1991, as compared with $595 in the United States in 1992. The differences in these costs may be due to differences in gun availability in the two countries. This suggests that increased gun control may reduce Canada's costs, especially those related to suicide.

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