Hospital Shootings Became More Common Over 25 Years

The number of hospital-based shootings rose steadily over the past quarter-century, a systematic review showed.

From 2000 to 2024, shootings increased from 6 to 34 events per year, representing a 6.4% increase each year, Sarayna McGuire, MD, MS, of the Mayo Clinic in Rochester, Minn., and colleagues reported in JAMA Network Open.

“We recognize that although hospital-related shootings constitute a small fraction of national firearm violence, their impact could be profound,” McGuire and colleagues wrote, noting there were more than 48,000 firearm-related deaths in 2022, per CDC data.

“In addition to the immediate injuries and fatalities sustained by staff, patients, and visitors, these events may produce an enduring psychosocial impact on communities and operational consequences for institutions, so much so that training for these events in the form of active shooter drills has been shown to be traumatizing to healthcare staff,” they wrote.

They added that the results “underscore the need for hospital-specific prevention strategies, including consideration of weapons screening processes, alongside broader societal and community efforts to address rising firearm violence.”

Earlier studies conducted from 2000 to 2011 and 2012 to 2016 have pointed to a rising incidence of hospital-based shootings, but there hasn’t been a “comprehensive updated analysis,” the researchers said. So they mined news and information sources for hospital shootings from Jan. 1, 2012 through Dec. 31, 2024.

They found 6,658 news articles and ultimately included 327 articles about unique hospital shooting events during this time period.

The number of shootings rose each year during those 12 years, from 14 to 34 events, representing an 8.4% increase each year. Overall incidence was 25.2 hospital shootings per year, they reported.

The most common shooting sites included the parking lot or outdoor sites (45.6%), hospital floors (18%), and the emergency department (17.7%).

Events primarily occurred in urban settings (96%) and Veterans Affairs hospitals accounted for 8% of the shootings.

Nearly half of shootings occurred in medium-sized hospitals (49.8%), but large hospitals had the highest rate of shootings (258.1 per 1,000 hospitals), and small hospitals had the lowest rate (17.6 per 1,000).

Excluding perpetrators, 189 individuals were injured or killed in the shootings. Healthcare workers accounted for 31.2% of these individuals, followed by patients (12.7%), law enforcement officers (12.7%), and visitors (9.5%).

As for perpetrators, a total of 333 were identified, with current or former patients making up the largest group (31.8%).

Suicide was the most common identifiable motive (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%).

Notably, nearly one-third of the shootings were potentially preventable by weapons screening, the researchers said.

Last year, the American Hospital Association released a report on the burden of violence that placed the total annual financial cost of violence to hospitals in 2023 at an estimated $18.27 billion, consisting of $3.62 billion in pre-event costs like prevention measures and $14.65 billion in post-event costs like healthcare, work loss costs, case management, staffing, and infrastructure repair.

“Overall, these events erode both the ability and perception of hospitals to function as secure and trusted care environments in the communities they serve,” McGuire and colleagues wrote.

Sources for news reports collected from 2012 through 2024 were EBSCO Regional Business News, ProQuest US Newsstream Collection, Gun Violence Archive, and Google News Search.

Limitations included that findings were subject to variability in public reporting, McGuire and colleagues noted, and that preventability estimates “should be viewed as conceptual rather than definitive.”