To determine the incidence and characteristics of hospital-based gun violence from 2000–2019.

A keyword-based search of the Nexis Uni database was conducted to identify hospital based shootings ((“shooting” w/5 “healthcare”) OR (“shooting” w/5 “health care”) OR (“shooting” w/5 “hospital”) OR (“shooting” w/5 “emergency room”) OR (“shooting” w/5 “ER”). Hospital based shootings were defined as any firearms discharge that occurred on hospital grounds in which at least one person was injured. Specialty hospitals and other healthcare facilities were excluded. Demographic, motive, and outcome data from news articles were abstracted by 2 independent reviewers with discrepancies resolved by a third reviewer. Motives were categorized according to a previously published classification schema.

We identified 146 hospital-based shootings. 88 shootings have occurred since 2010. 133 of the shooters were male (91%), with a median age of 46. 77 (53%) shooters were killed, 49 from suicide (34%). Shootings were most frequently motivated by social violence (n=32, 22%).

Hospital-based shootings are not a rare occurrence, with middle-aged male shooters as the most common perpetrators. These events appear to be increasing over time and evidence-based mitigation strategies should be investigated.