Hospital shootings are becoming more frequent

For the study, researchers conducted a systematic review of shootings that occurred at U.S. acute care hospitals between Jan. 1, 2012, and Dec. 31, 2024. They also used previously published data to evaluate the overall trend in U.S. hospital shootings between Jan. 1, 2000, and Dec. 31, 2024. Events were identified by searching through news databases and the Gun Violence Archive and were only included if they occurred within or on immediate hospital property and resulted in at least one injury.

Overall, the researchers found that the number of hospital shootings increased from six to 34 events per year between 2000 and 2024, representing a 6.4% increase each year. When reviewing 2012 to 2024 specifically, they found that the number of hospital shootings grew from 14 to 34 events, representing an 8.4% increase each year. 

Almost 50% of shootings occurred in medium-sized hospitals, but large hospitals had the highest rate of shootings at 258.1 per 1,000 hospitals. Small hospitals had the lowest rate at 17.6 shootings per 1,000 hospitals.

The most common sites of shootings were the parking lot or outdoor sites (45.6%), hospital floors (18%), and the ED (17.7%). Shootings were less common in the ICU (0.3%), hospital entrance (3.4%), lobby or waiting area (3.7%), or other nonpatient care areas (3.7%).

Excluding perpetrators of the events, 189 individuals were either injured or killed in the shootings. Of these individuals, 31.2% were healthcare workers, 12.7% were patients, 12.7% were law enforcement officers, and 9.5% were visitors. 

A total of 333 perpetrators were identified, with 31.8% being current or former patients. Roughly 80% of perpetrators were male, and the median age was 38 years old. The most commonly identifiable motive was suicide (30.9%), followed by mental instability (15.6%), personal grudge (11.6%), community spillover (11.6%), inadvertent discharge (4.9%), euthanasia (4.3%), and attempted escape from custody (4%).

The researchers also noted that almost a third of hospital shootings could have potentially been prevented with weapons screening. 

Last year, the American Hospital Association released a report estimating the total financial cost of violence to hospitals to be $18.27 billion in 2023. This included $3.62 billion in pre-event costs like prevention measures and $14.65 billion in post-event costs, such as healthcare, work loss costs, case management, staffing, and infrastructure repair.

To reduce the risk of violence, hospital leaders can bolster their emergency management policies, build community partnerships and education campaigns, upgrade their security systems, and ensure their facilities have adequate lighting and clear exit routes.

"Overall, these [shooting] events erode both the ability and perception of hospitals to function as secure and trusted care environments in the communities they serve," the researchers wrote.