— -- Gunshot wounds are costing the U.S. hundreds of millions every year, much of it falling on government health insurance and the poor, according to a new study of firearm injuries in the American Journal of Public Health.
The U.S. has the highest rates of gun homicides in the developed world, approximately 25 times more firearm deaths than other high-income countries, according to the study.
Every year, the cost for treating people with gunshots wounds reaches approximately $734 million in initial hospital costs, racking up more than $6.6 billion between 2006 and 2014.
"This is a signal that this is not simply an issue for the justice system, this is very much a medical issue," Dr. Charlie Branas, the chair of the Department of Epidemiology at the Columbia University Mailman School of Public Health told ABC News. He said the study could help show policy makers that trauma centers need more help and funding to treat these patients effectively.
According to the study, the government shoulders approximately 40 percent of the initial hospitalizations for firearm injuries through Medicaid and Medicare and more than 80 percent of those who self-paid had incomes below the 50th percentile.
"The responsibility for payment falls primarily on government payers and the uninsured," the authors wrote.
To understand the financial burden of treating these injuries, researchers from Stanford University looked at national data, between 2006 and 2014, from the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality.
More than 267,000 people in that time were admitted for firearm injuries to hospitals, which reported statistics, nationwide. The highest proportion of injuries -- 43 percent -- were reported in the South. The Midwest and West each accounted for 20 percent of the injury locations. The Northeast accounted for approximately 16 percent of where the injuries took place.
The study found that 29.1 percent of the firearm injury patients paid via Medicaid, 29.4 percent self-paid, 21.4 percent used private insurance and 6 percent of those injured paid via Medicare. In total, the government is estimated to have covered 2.7 billion or approximately 41 percent of the overall costs to treat gun shot wounds during the study period.
Medicaid patients had the highest per-incident cost at an average of about $30,000. Privately insured patients had a per-incident cost of approximately $23,000 on average.
But these numbers likely underestimate the overall cost for treating gunshot wound victims, since they do not take into account long-term health care, rehabilitation and lost work income. Additionally, the study authors point out the government may have spent more via federal funding initiatives for hospitals dedicated to trauma and firearm treatment.
The true cost to patients, hospitals and the government are likely much higher.
"What is hard to interpret from this work is how big the cost of firearm injuries is or isn't," Dr. Ted Miller, a Senior Research Scientist at the Pacific Institute for Research and Evaluation, a nonprofit organization that focuses on conducting research on health and social issues, and criminal justice, told ABC News.
Another hidden cost to the government for gunshot wounds, Miller said, is the many patients who come into the hospital uninsured and are put on Medicaid. So the government may actually be covering more than the 41 percent of initial hospitalization cost noted in the study.
His group's research, which was not affiliated with the study, points to much higher costs over time for "lifetime hospital payments."
Branas said this number doesn't even include the long term effects on communities, families, and people affected by violence.
"I think that hospitalizations are only the tip of the iceberg in terms of cost of firearm injuries," Branas said. "There is a much bigger portion of this that is underwater."
In addition to medical costs, he said, gunshot wounds and the care they require come with "legal cost and pain and suffering cost."
The study authors said more research is needed to fully understand the comprehensive costs of firearm injuries. This data was intended to help policy makers allocate funds appropriately to the trauma and treatment centers that care for these patients.