U.S. acute care hospital shootings, 2012-2016: A content analysis study

Work. 2019;64(1):77-83. doi: 10.3233/WOR-192970.

Abstract

Background: Healthcare workers experience a disproportionately high frequency of workplace assaults. Incidents involving firearms are of particular concern.

Objective: To provide detailed characterizations of recent hospital shootings to better inform prevention and mitigation strategies.

Methods: Quantitative content analysis of reports involving hospital shootings resulting in casualties derived from web searches for each year from 2012-2016. Data were abstracted independently by two investigators, with differences resolved by consensus. Data were compared between subgroups by chi-square test, Fisher's exact test, or Kruskal-Wallis test, as appropriate.

Results: Eighty-eight shootings occurred in 86 hospitals resulting in 121 firearms-related casualties, including 54 victims and 67 perpetrators. Case fatality rates were 55.6% (n = 30) and 70.1% (n = 47), respectively. The most frequent sites involved were the emergency department, (n = 27, 30.3%), patient room (n = 19, 21.3%), and parking lot (n = 13, 14.6%). Grudge (n = 17, 19.3%), suicide (n = 14, 15.9%), and mental instability (n = 13, 14.8%) were the most common explanations for these shootings. Four inadvertent discharges occurred and were more likely to involve a female perpetrator (p = 0.03). Shootings were most frequent during summer (p = 0.03) and winter (p = 0.04).

Conclusions: Out study findings on location and seasonal patterns can guide the development or improvement of prevention and mitigations strategies for hospital shootings.

Keywords: Firearm violence; active shooter; acute care; hospital; quantitative content analysis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Firearms
  • Hospitals / statistics & numerical data*
  • Humans
  • Male
  • Mental Disorders
  • Middle Aged
  • Occupational Injuries / epidemiology
  • Patients' Rooms / statistics & numerical data
  • Seasons
  • Suicide / statistics & numerical data
  • United States / epidemiology
  • Workplace Violence / statistics & numerical data*
  • Wounds, Gunshot / epidemiology*
  • Wounds, Gunshot / mortality