Evidence map›Paper›PMID 39968652›Full record

ArticleAnnals of surgery2026

Health Insurance Instability Following Firearm Injury: A Matched Cohort Study.

George Karandinos, Mia Giuriato, Peter T Masiakos, Chana A Sacks, Zirui Song

Abstract read
In one paragraph

Article in Annals of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

George KarandinosDivision of General Internal Medicine and Mongan Institute, MGH Gun Violence Prevention Center, Massachusetts General Hospital, Boston, MA.ORCID 0009-0002-0398-0692
Mia GiuriatoDepartment of Health Care Policy, Harvard Medical School, Boston, MA.
Peter T MasiakosHarvard Medical School, Boston, MA.
Chana A SacksDivision of General Internal Medicine and Mongan Institute, MGH Gun Violence Prevention Center, Massachusetts General Hospital, Boston, MA.
Zirui SongDivision of General Internal Medicine and Mongan Institute, MGH Gun Violence Prevention Center, Massachusetts General Hospital, Boston, MA.

Funding

Inequities in Health Outcomes in the Twenty-First Century: Understanding New Causes and the Impact of Delivery System Reforms on Health Care DisparitiesDP5OD024564 · OD · HARVARD MEDICAL SCHOOL · PI SONG, ZIRUI · 2017 to 2021
$2.1M
NIH HHS DP5 OD024564
6 · The paper itself

Abstract

objectiveTo estimate the risk of insurance instability following firearm injury.

backgroundHealth insurance instability is associated with negative clinical outcomes. After nonfatal firearm injury, continuity of health care is particularly important given substantially increased physical, mental, and rehabilitative needs and related health care spending.

methodsUsing 2007 to 2022 commercial insurance claims data, we studied 3653 survivors and 17,422 matched controls to investigate the risk of health insurance instability associated with firearm injury. Individuals were matched on age, diagnostic cost group risk score, year, month, plan type, drug coverage, sex, metropolitan statistical area, state, and enrollee category.

resultsThe mean age of survivors was 30.5 years, 83.7% were male, and 39.2% were primary enrollees, with observable characteristics closely balanced between exposed and control groups after matching. Within 1 year of injury, 36.1% of survivors experienced insurance instability compared with 28.1% of matched controls-an attributable risk of 8.0 (95% CI: 5.8, 10.1) and adjusted hazard ratio of 1.34 (95% CI: 1.26, 1.42). For survivors with more severe injuries, 37.3% experienced insurance instability compared with 27.6% of matched controls-an attributable risk of 9.8 (95% CI: 6.7, 12.9) and adjusted hazard ratio of 1.43 (95% CI: 1.31, 1.56). On average, firearm-injured primary enrollees experiencing insurance instability provided coverage for 0.84 dependents (spouses and children) at the time of their insurance status change.

conclusionsFirearm injury was followed by increased insurance instability among survivors, with increased risk following more severe injuries. Insurance instability may disrupt care and shift costs to the public through public insurance enrollment and uncompensated care for the uninsured.

Indexed as

Insurance CoverageInsurance, HealthWounds, GunshotAdolescentAdultCase-Control StudiesFemaleHumansMaleMiddle AgedUnited StatesYoung Adultfirearm injuryhealth insurance churnhealth insurance instabilitytrauma

Identifiers

PMID39968652
PMCPMC13289595

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.