Publications (2)0 Total impact
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ABSTRACT: The relationship between injuries sustained in a motorcycle crash (MCC) by unhelmeted motorcyclists and the multitude of costs associated with those injuries has been a decades-long debate. Results from research addressing injuries and mortality due to helmet use in MCCs demonstrates that unhelmeted motorcyclists experience more severe injuries, resulting in higher health care costs and an increased likelihood of requiring care beyond the hospital in other facilities. However, a link between injury severity and hospital costs has not been established with its spillover effect onto health insurance providers. This retrospective study was designed to delineate the health care and insurance costs of adult trauma patients admitted to a Level 1 trauma center due to an MCC. The study included adult trauma patients 18 years of age or older admitted to a Level 1 trauma center due to an MCC between January 1, 2005, and December 31, 2010. The center is a receiving hospital for the central third of a Midwestern state, serving a medium-sized city as well as rural and isolated population areas. Patients were stratified into 2 groups based on helmet use. Patient variables included mechanism of injury, clinical characteristics, total units of blood used, intensive care unit (ICU) length of stay (LOS), hospital LOS, days on a ventilator, mortality, number of procedures during hospital stay, primary payor, discharge location, and total hospital charges. A linear regression model was used to predict the charges associated with the severity of injuries. A significant difference was found for total hospital charges. The mean total hospital charge for helmeted patients was $4184.26 compared to $7383.31 for unhelmeted patients. The prediction model was statistically significant, indicating that not wearing a helmet starts the patient at a cost of $3199.06. The cost of treatment for patients who wore helmets was $256.93 for each incremental increase in Injury Severity Score (ISS) compared to $537.57 for unhelmeted patients. ICU LOS, hospital LOS, and vent days were statistically significant, with durations longer for unhelmeted patients. Helmeted patients also required more units of blood. The total number of procedures for each patient approached significance, with the unhelmeted group requiring more procedures. The goal of the study was to delineate the medical costs associated with helmet use and nonuse in motorcyclists. The results demonstrate that medical costs due to an MCC for an unhelmeted motorcyclist were significantly higher than for a helmeted motorcyclist. These costs were paid by providers of health insurance, mainly Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), Medicaid, and commercial insurance.Traffic injury prevention 03/2012; 13(2):144-9.
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ABSTRACT: By 2030 it is expected the elderly will comprise 25 percent of the drivers in the United States. It is also estimated that currently in the United States alone, 500 older adults are injured each day in motor vehicle crashes (MVCs). Current research has not been able to consistently produce a direct connection between MVCs and specific age-related changes. It is speculated that crash rates are more likely linked to an interaction between driver characteristics and driving conditions as well as the driving environment. Sundowner's syndrome occurs in older drivers starting in the late afternoon through early evening (generally between 3:00 pm and 8:00 pm) and involves behaviors such as confusion, disorientation, and restlessness. The following retrospective study was designed to assess the frequency of older drivers admitted to a trauma service due to an MVC based on the time of day of the MVC compared to younger and middle-aged drivers. The study included all adult trauma patients ≥ 21 years of age admitted to a Level 1 trauma center due to a, MVC, in which they were the driver of the vehicle, between January 1, 2005, and December 31, 2010. A 3 (Injury Time Period) × 7 (Age Category) chi-square was performed to assess whether there was a disproportionate number of patients admitted as a function of time of injury and age. The overall chi-square was statistically significant. Consequently, a 3 × 7 analysis of variance (ANOVA) was performed on injury severity score (ISS). Tukey's posttest revealed that ISS was highest during the early evening time period. The evidence of the early evening time period having a differential impact on older drivers is through a demonstration of an Injury Time Period × Age Category interaction. This interaction was found to substantiate the hypothesis that older drivers have a disproportionately higher rate of injury due to an MVC during the early evening time period than younger and middle-aged drivers. In identifying the early evening's time period as a time in which older drivers are more likely to experience injury from an MVC than younger and middle-aged drivers, we believe that our research adds insight into why age restrictions have not been successful in reducing crash rates in the older driver population. It is the compound effect of age-related changes and environmental conditions that contributes to the higher proportion of MVCs. Age restrictions alone do not take into account environmental conditions.Traffic injury prevention 12/2011; 12(6):593-8.