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Little is known about the healthcare and economic burdens of non-fatal firearm injuries for children/youth beyond the initial admission. This study sought to estimate healthcare utilization and total direct healthcare costs of non-fatal powdered and non-powdered (air gun) firearm injuries 1-year post-injury. Using administrative data from 2003 to 2018 on all children/youth 0–24 years old in Ontario, Canada, a matched 1:2 cohort study was conducted to compare children/youth who experienced powdered and non-powdered firearm injuries with those who did not. Mean and median number of healthcare encounters and costs, and respective 95% confidence intervals (CIs) and interquartile ranges (IQRs), were estimated for both weapon type groups and controls and by intent. Children/youth who experienced a powdered and non-powdered firearm injury had a higher number of healthcare encounters and costs per year than those who did not. Mean 1-year costs for those with powdered and non-powdered firearm injuries were $8825 ($8007–$9643) and $2349 ($2118–$2578), respectively, versus $812 ($567–$1058) and $753 ($594–$911), respectively, for those without. Mean 1-year costs were highest for handgun injuries ($12,875 [95% CI $9941–$15,808]), and for intentional assault-related ($13,498 [$11,843–$15,153]; $3287 [$2213–$4362]), and intentional self-injuries ($14,773 [$6893–$22,652]; $6005 [$2193–$9817]) for both powdered and non-powdered firearm injuries, respectively.      Conclusion : Firearm injuries have substantial healthcare and economic burdens beyond the initial injury-related admission; this should be accounted for when examining the overall impact of firearm injuries.   What is Known:  • Child/youth firearm injuries have significant health and economic burdens.  • However, existing work has mainly examined healthcare utilization and costs of initial admissions and/or have been limited to single-center studies and no studies have provide cost estimates by weapon type and intent.  What is New:  • Children/youth who suffered powdered firearm injuries had higher mean healthcare utilization and costs than those with non-powdered firearm injuries as well as comparable healthy children/youth.  • Mean 1-year costs were highest for handgun injuries ($12,875), and for intentional assault-related ($13,498; $3287), and intentional self-injuries ($14,773; $6005) for powdered and non-powdered firearm injuries, respectively.

Healthcare utilization and costs following non-fatal powdered and non-powdered firearm injuries for children and youth