Hospital-based shootings in the United States, 2000-2019

Introduction: Violence in healthcare settings, particularly directed toward healthcare workers, has received increasing attention in the United States (US). However, there is limited evidence on trends in hospital-based gun violence. We aimed to better understand the characteristics of US hospital-based shootings over two decades. Methods: A search of Nexis Uni was conducted for newspaper articles, newswires, web news articles, or magazines mentioning hospital-based shootings during the period from 2000 to 2019. Articles were screened for relevance, and data were subsequently extracted and categorized by two independent reviewers. Results: From 2000 to 2019, we identified 148 hospital-based shootings with 241 victims. Mean number of shootings increased from 3.4/year during 2000-2004 to 8.4/year during 2005-2009 (rate ratio [RR]: 2.5, 95 percent confidence interval [CI]: 1.4, 4.3), to 11.2/year during 2010-2014 (RR: 1.3, 95 percent CI: 0.9, 2.0) but decreased to 6.6/year during 2015-2019 (RR: 0.6, 95 percent CI: 0.4, 0.9). An overwhelming majority (91 percent) of shooters were male with a median age of 46. The most frequent motive was the spillover of social violence (22 percent). The majority (59 percent) of events involved a single victim, although 14 percent had three or more victims. Discussion: Hospital-based shootings remain a persistent threat, with the 2010-2014 period representing increased risk. While motives were varied, spillover of social violence was the most frequent. These findings can potentially inform prevention and mitigation strategies for hospital-based gun violence.