Highway crash costs in the United States by driver age, blood alcohol level, victim age, and restraint use

Miller, Ted R.; Lestina, Diane C.; Spicer, Rebecca Shannon

doi:10.1016/s0001-4575(97)00093-6

Cited by 85 publications

(52 citation statements)

References 13 publications

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“…Alcohol Drugs, 71, 384-394, 2010) Medicine, 1990;Maio et al, 1994). Drinking and driving is a particular problem (Miller et al, 1998), with approximately 25% of 18-to 19-year-old drivers involved in fatal auto accidents having a positive blood alcohol concentration (Subramanian, 2003).Reaching at-risk youth and designing effective interventions for alcohol-related problems is critical. One evidence-based approach is to intervene with youth receiving emergency medical treatment for an alcohol-related injury.…”

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confidence: 99%

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Cost-Effectiveness of a Motivational lntervention for Alcohol-Involved Youth in a Hospital Emergency Department

Neighbors¹,

Barnett²,

Rohsenow³

et al. 2010

J. Stud. Alcohol Drugs

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ABSTRACT. Objective: Brief interventions in the emergency department targeting risk-taking youth show promise to reduce alcohol-related injury. This study models the cost-effectiveness of a motivational interviewing-based intervention relative to brief advice to stop alcoholrelated risk behaviors (standard care). Average cost-effectiveness ratios were compared between conditions. In addition, a cost-utility analysis examined the incremental cost of motivational interviewing per qualityadjusted life year gained. Method: Microcosting methods were used to estimate marginal costs of motivational interviewing and standard care as well as two methods of patient screening: standard emergencydepartment staff questioning and proactive outreach by counseling staff. Average cost-effectiveness ratios were computed for drinking and driving, injuries, vehicular citations, and negative social consequences. Using estimates of the marginal effect of motivational interviewing in reducing drinking and driving, estimates of traffic fatality risk from drinking-and-driving youth, and national life tables, the societal costs per quality-adjusted life year saved by motivational interviewing relative to standard care were also estimated. Alcohol-attributable traffic fatality risks were estimated using national databases. Results: Intervention costs per participant were $81 for standard care, $170 for motivational interviewing with standard screening, and $173 for motivational interviewing with proactive screening. The cost-effectiveness ratios for motivational interviewing were more favorable than standard care across all study outcomes and better for men than women. The societal cost per quality-adjusted life year of motivational interviewing was $8,795. Sensitivity analyses indicated that results were robust in terms of variability in parameter estimates. Conclusions: This brief intervention represents a good societal investment compared with other commonly adopted medical interventions. (J. Stud. Alcohol Drugs, 71, 384-394, 2010) Medicine, 1990;Maio et al., 1994). Drinking and driving is a particular problem (Miller et al., 1998), with approximately 25% of 18-to 19-year-old drivers involved in fatal auto accidents having a positive blood alcohol concentration (Subramanian, 2003).Reaching at-risk youth and designing effective interventions for alcohol-related problems is critical. One evidence-based approach is to intervene with youth receiving emergency medical treatment for an alcohol-related injury. Monti et al. (1999Monti et al. ( , 2007 and Spirito et al. (2004) have established that brief interventions conducted with adolescents in an emergency department (ED) reduce subsequent injuries and driving after drinking. Studies with older populations have also shown that ED interventions for problem alcohol use are efficacious in reducing alcohol-related consequences (Gentilello et al., 1999;Helmkamp et al., 2003;Longabaugh et al., 2001). In fact, the American College of Surgeons has mandated as a criterion for accreditation tha...

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confidence: 99%

mentioning

confidence: 99%

Cost-Effectiveness of a Motivational lntervention for Alcohol-Involved Youth in a Hospital Emergency Department

Neighbors¹,

Barnett²,

Rohsenow³

et al. 2010

J. Stud. Alcohol Drugs

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“…The computations used a 2.5% discount rate, the same rate used in all our other recent injury cost studies. 9,[17][18][19][20] This rate lies at the conservative end of the 1% to 3% range that the economic evidence has cause the US Supreme Court (1983) 28 to conclude as most appropriate in determining tort liability compensation.Cost per nonfatal case was applied to each injury according to the 3-digit ICD-9 code. The per-case cost is an average that takes into account the distribution of hospitalization status for that particular ICD-9 group.…”

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confidence: 99%

Incidence and Costs of 1987–1994 Childhood Injuries: Demographic Breakdowns

2000

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ABSTRACT. Objectives. Injuries pose a threat to health and well-being and are a major source of medical spending in the United States for children and youth 0 to 21 years of age. This study provides national estimates of the incidence of fatal and nonfatal childhood injuries and comprehensive cost estimates by age, gender, race, family income, metropolitan residence, and place of incident.Methods. Eight years of National Health Interview Survey data (1987 to 1994) were used to estimate nonfatal injury incidence rates among children and youth 21 years of age and younger. The survey documents all medically attended or temporarily disabling injuries within the 2 weeks before the interview. Injuries were defined as diagnoses 800 -995 in the International Classification of Diseases, Ninth Revision, excluding late effects cases. Fatality counts came from 1994 Vital Statistics.Estimates of the costs of injuries (1994 US dollars) included medical spending, lost future work, and lost quality of life. Medical payments included spending on hospital and professional services, rehabilitation, prescriptions, home health care, and medical equipment. Lost future work and lost quality of life consisted of the present value of work that children will be unable to do as adults if they are killed or permanently disabled combined with the pain and suffering that children and their families experience because of the injury. Cost estimates excluded parental income losses from work missed, property damage, legal costs, and insurance claims-adjustment costs related to permanent disability and death.Results. Incidence. A total of 3073 injury episodes for 3058 children were obtained from 8 years of National Health Interview Survey data. This represents 20.6 million children in the United States who were injured each year, or ϳ25 per 100 children. This translates to 56 000 nonfatal injury episodes each day that require medical attention or limit children's activity. For fatal injuries, the rate was 38 children per 100 000. The nonfatal injury rate for males (mean: 30; 95% confidence interval [CI]: 29,31) was higher than the rate for females (mean: 20; 95% CI: 19,21); the fatal injury rate for males was more than twice that of females.Injury rates increased with age. Children 0 to 9 years of age had the lowest rate of nonfatal injury. Rates for nonfatal injury among children 0 to 4 years of age were lower (mean: 20; 95% CI: 18,21) than those for the 5 to 9 age group (mean: 22; 95% CI: 20,23). However, the rate for fatal injuries (21 per 100 000) among the 0 to 4 age group was higher than the 5 to 9 age group (9 per 100 000). Nonfatal injury rates for children 10 years of age and older were higher, with the highest estimated injury rates in late adolescence (15-19 years; mean: 31; 95% CI: 29,33).Nonfatal injuries occurred at higher rates among white children (mean: 27; 95% CI: 26,28) than black children (mean: 19; 95% CI: 17,21) or children from other racial backgrounds (mean: 13; 95% CI: 10,16). The reverse was true for fatal injuries, with...

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“…Due to a number of physiological changes (such as osteoporosis and the thinning of cortical bone), older people tend to exhibit a greater injury risk for a given crash exposure compared to younger people (Morris et al, 2002(Morris et al, , 2003Kent et al, 2005Kent et al, , 2009. Older people are also frailer than younger -they tend to exhibit greater morbidity and fatality risk for a given injury compared to younger people (Bulger et al, 2000;Evans, 2001;Martinez et al, 1994;Miller et al, 1998;Miltner and Salwender, 1995;Peek-Asa et al, 1998). As a result, older people tend to be injured (even fatally) in lowerseverity collisions that may be normally survivable for younger persons (Kent et al, 2005).…”

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Epidemiology of injuries sustained by rear-seat passengers in frontal motor vehicle crashes

Bose

Crandall

Forman

et al. 2017

Journal of Transport & Health

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ObjectiveAdvanced occupant protection systems in motor-vehicles (e.g., seat belts and airbags), while widely adopted for front-seat passengers, are either absent or offer disproportionally lower safety to rearseat passengers in similar crashes. Optimization of advanced restraint systems for the rear-seat environment will require a detailed understanding of epidemiology and associated risk factors for injuries sustained by rear-seat passengers. Thus, the objective of the study is to use national level motor-vehicle travel and crash data to quantify rear-seat travel exposure, and determine the descriptive characteristics and the injury outcomes for rear-seat passengers involved in frontal collisions. MethodsWhile U.S. travel data from the 2009 National Household Travel Survey was used to determine rear-seat travel estimates, crash data from 2001 to 2010 National Automotive Sampling System Crash Worthiness Data System was used to enroll rear-seat passengers injured in a frontal crash. The descriptive epidemiology of rear-seat crash victims was separately done for the three age-groups: children (8 to 15 (8-15 years old), adults (16 to 59 (16-59 years old), and senior adults (60+). ResultsThe study indicated that senior adults in rear-seats were associated with a significantly higher rate of sustaining fatal (6%) and severe injuries (16% for MAIS 3+ injuries) in comparison to the younger cohorts. The distribution of severe injuries further indicated that the thorax was the most frequently injured region across all age groups irrespective of the belt-use status. ConclusionsFindings of the study conclude that while rear-seat travel in the U.S. is still very low and improving belt usage is a primary concern among rear-seat passengers; however, the epidemiology supports the need for adapting rear-seat restraint performance for effective protection for all groups of rear-seat passengers.Keywords: Rear seat passenger; seatSeat belt; motorMotor vehicle crash; airbagAirbag; frontalFrontal crash; optimizedOptimized restrain systems trips in a motor-vehicle involve a rear-seat passenger , and rear seat occupants are present in approximately 13-17% of all tow-away collisions (Parenteau and Viano, 2003). As a result of low-exposure, rear-seat passengers are responsible for less than 10% of overall fatalities and injured victims (USDOT,(USDOT, 1997. Consequently, this cohort of vehicle passengers has traditionally received less attention than front seat occupants in terms of targeted injury countermeasures and understanding of the relative risk factors applicable to the rear-seat environment ).Various studies indicate that for children, a car's rear seat is safer than the front seat (Smith and Cummings, 2004;Kuppa et al., 2005). Moreover, recent research indicate that the fatality and injury-reducing efficacy of the rear seat highly depends on the passenger's age since the rear seat has been reported to be less safe than the front seat for older persons. Kuppa et al. (2005) reported a greater fatality risk for rear s...

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Highway crash costs in the United States by driver age, blood alcohol level, victim age, and restraint use

Cited by 85 publications

References 13 publications

Cost-Effectiveness of a Motivational lntervention for Alcohol-Involved Youth in a Hospital Emergency Department

Cost-Effectiveness of a Motivational lntervention for Alcohol-Involved Youth in a Hospital Emergency Department

Incidence and Costs of 1987–1994 Childhood Injuries: Demographic Breakdowns

Epidemiology of injuries sustained by rear-seat passengers in frontal motor vehicle crashes

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