The emerging infrastructure of US firearms injury data
The emerging infrastructure of US firearms injury data
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DOI：
10.1016/j.ypmed.2022.107129
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发表时间：
2022-11-30
影响因子：
5.1
通讯作者：
Parker, Susan T.
中科院分区：
文献类型：
--
作者：
Barber, Catherine;Cook, Philip J.;Parker, Susan T.
对于美国的每一起致命枪击事件，来自验尸官或法医、警察部门和其他来源的报告的详细信息都记录在国家暴力死亡报告系统中。对于非致命性枪击事件，没有这样的系统，这远远超过了死亡人数。医院数据系统已经到位，经过一些改进，可以提供可靠的地方、州和国家火器伤害估计数。这种估计是可能的，因为大多数火器伤害是在医院治疗的，医院通常会对所有受伤情况指定“外部伤害原因”代码。联邦卫生机构监督着许多集中医院数据的数据系统。目前正在解决的挑战是公众访问、及时性和意图编码的准确性。（医院将许多枪支袭击错误地归类为事故。执法机构提供了关于犯罪情况下枪击事件的详细数据，包括没有在医院治疗的枪击事件。联邦调查局的统一犯罪报告（UCR）系统汇总了来自各机构的数据。联邦调查局从2021年开始对这一系统进行了彻底的改革，导致机构参与率急剧下降，无法进行有效的国家估计。这项改革要求各机构报告事故级别的数据，而不是过去90年所要求的汇总统计。目前正在努力增加对新系统的参与，并恢复其作为国家犯罪估计数主要来源的地位。与此同时，一些警察部门提供了非致命枪击案件的数据。我们讨论了从医院和警察那里生成及时、准确、公开的数据所需的其他改革。
For every fatal shooting in the United States, detailed information from reports of coroners or medical examiners, police departments, and other sources is recorded in the National Violent Death Reporting System. There is no such system in place for nonfatal shootings, which far outnumber fatalities. Hospital data systems are in place that could, with some improvements, provide access to reliable local, state and national estimates of firearm injuries. Such estimates are possible because most firearms injuries are treated in hospitals, and hospitals routinely assign "external cause of injury" codes to all injury encounters. Federal health agencies supervise a number of data systems that centralize hospital data. Challenges currently being addressed are public access, timeliness, and accuracy of coding of intent. (Hospitals misclassify many firearm assaults as accidents.) Law enforcement agencies provide detailed data on shootings in criminal circumstances, including shootings that are not treated in a hospital. The FBI's Uniform Crime Reports (UCR) system aggregates data from agencies. The FBI instituted a radical reform of this system beginning in 2021, resulting in a sharp agency participation drop that prevents valid national estimates. The reform requires agencies to report incident-level data instead of summary counts, which is all that was required for the previous 90 years. There are ongoing efforts to increase participation in the new system and restore its former status as the leading source of national crime estimates. In the meantime, data on nonfatal gunshot cases are available from a number of police departments. We discuss additional reforms needed to generate timely, accurate, publicly accessible data from hospitals and police.