Medical records are generally inadequate in firearm injury surveillance because emergency physicians and trauma surgeons rarely record information that is not immediately relevant to the care of patients, many shooting victims are too badly injured or chemically impaired to provide a reliable history when they are brought to the emergency room, and some victims provide inaccurate or misleading information to avoid arrest or retaliation.
Without detailed information about the location and circumstances of each shooting, firearm injury surveillance provides little more than wound and body counts. This level of information may suffice for national and State firearm injury surveillance but it is not adequate for localities. Community officials need more complete data to plan, implement, and evaluate countermeasures. To generate the necessary level of detail, hospital records must be supplemented by other data sources. Such sources include emergency medical, medical examiner, and police records. Data collection is simplified if reports are stored in an electronic format, particularly because manual linkage of records is cumbersome and time-consuming. Health and law enforcement data should be linked to serve the interests of both public health and law enforcement, and effective firearm injury surveillance systems should be developed. Examples of State and local efforts to develop such systems are cited. 25 references