Uninsured patients hospitalized for gunshot wounds in Florida are discharged significantly faster than patients with coverage, according to a recent analysis of state hospital billing data.
KFF Health News and The Trace, a news outlet focused on gun violence, reviewed more than 20 million inpatient hospitalizations reported to the Florida Agency for Health Care Administration from 2018 to 2024, and identified 20,255 gunshot wound visits. Published June 29, the analysis is what the newsrooms called a first-of-its-kind look at how insurance status tracks with care for gun injury patients.
Uninsured patients — the largest single group treated for firearm injuries — made up about 25% of hospitalizations and stayed about six days, on average. That was roughly three-quarters as long as privately insured patients and less than half as long as patients on traditional Medicaid. Overall, uninsured stays ran about 25% shorter than those of the privately insured.
Among the most severely injured patients, uninsured individuals stayed three fewer days on average than insured patients.
The disparity existed across hospital size, location and ownership type, including safety-net facilities that are federally required to treat patients regardless of their ability to pay. The disparity narrowed but did not disappear after adjusted for patient age and injury severity, according to the analysis.
Nearly half of the gunshot patients were Black. About a quarter of nonwhite patients were uninsured, compared with fewer than one-fifth of white patients. Once discharged, patients with commercial insurance or traditional Medicaid were more than twice as likely as uninsured patients to receive follow-up care such as rehabilitation or home health, the analysis found.
Hospital spokespeople disputed the findings, telling KFF Health News and The Trace that treatment and discharge decisions turn on clinical need, not coverage.
The Florida Hospital Association also rejected the report’s premise.
“The suggestion that Florida hospitals make discharge decisions based on a patient’s insurance status is inconsistent with both federal requirements and the mission of our hospitals,” President and CEO Mary C. Mayhew told Becker’s in a statement.
Discharge decisions are based on clinical readiness and patient safety, she said, adding that acute care hospitals routinely care for patients long after they need hospital-level services because post-acute, behavioral health, rehabilitation or community-based resources are unavailable. Those delays accounted for more than 356,000 hospital days statewide in 2025, Ms. Mayhew said.
The findings land as the uninsured population is projected to grow. National research has similarly found that uninsured patients hospitalized for traumatic injuries have shorter stays than insured patients — a pattern researchers link to the time insurers require to authorize transfers to post-acute care.
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