1
|
Gómez García AR, Herrera Vinelli IH, Arias Ulloa CA, Jara Costales J. Pérdidas laborales asociadas a la mortalidad por lesiones en accidentes de tránsito: estimaciones provinciales de ecuador. Rev Salud Publica (Bogota) 2021. [DOI: 10.15446/rsap.v23n2.91072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo Estimar los años potenciales de vida perdidos (APVP) y los años potenciales de vida laboral perdidos (APVLP) en la población en edad laboral asociados a los fallecimientos prematuros por lesiones en accidentes de tránsito para las 24 provincias de Ecuador.
Métodos Se emplearon fuentes de información estadística (registro de defunciones CIE-10 V01 a V89 y censo poblacional) para estimar los APVP y APVLP en edades laborales (15 a 64 años de edad) por sexo y provincias. Además, se calcularon la tasa cruda y específica (edades laborales) y la edad media (IC95%).
Resultados La mayoría de las muertes en edad laboral por lesiones en accidentes tránsito estuvo en hombres con edades jóvenes y en las provincias de las regiones amazónica (Orellana y Sucumbíos) y la costa del Pacífico del país (Los Ríos). El número de APVLP se estima en 69 314 años, mientras que los APVP asciende a 94 567 años, las provincias de Guayas y Pichincha acumulan la mayor cantidad de APVP y APVLP.
Conclusiones Los años perdidos estimados por muertes prematuras por esta causa representan un problema de salud pública y un importante coste laboral para el desarrollo del país. Los resultados encontrados refuerzan la necesidad de intensificar la mejora de programas y actuaciones públicas en seguridad vial.
Collapse
|
2
|
Banstola A, Kigozi J, Barton P, Mytton J. Economic Burden of Road Traffic Injuries in Nepal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124571. [PMID: 32630384 PMCID: PMC7345187 DOI: 10.3390/ijerph17124571] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 12/26/2022]
Abstract
The evidence of the economic burden of road traffic injuries (RTIs) in Nepal is limited. The most recent study, conducted in 2008, is now considered outdated because there has been a rapid increase in vehicle numbers and extensive road building over the last decade. This study estimated the current economic costs of RTIs in Nepal, including the direct costs, productivity costs, and valuation of pain, grief, and suffering. An incidence-based cost-of-illness analysis was conducted from a societal perspective, employing a bottom-up approach using secondary data. All costs incurred by the patients, their family members, and costs to society were estimated, with sensitivity analyses to consider uncertainty around the data estimates available. Productivity loss was valued using the human capital approach. The total costs of RTIs in 2017 were estimated at USD 122.88 million. Of these, the costs of productivity loss were USD 91.57 million (74.52%) and the pain, grief, and suffering costs were USD 18.31 million (14.90%). The direct non-medical costs were USD 11.50 million (9.36%) whereas the direct medical costs were USD 1.50 million (1.22%). The economic costs of RTIs increased by threefold since 2007 and are equivalent to 1.52% of the gross national product, indicating the growing national financial burden associated with preventable RTIs.
Collapse
Affiliation(s)
- Amrit Banstola
- Faculty of Health and Applied Sciences, University of the West of England, Bristol BS16 1QY, UK;
- Health Economics Unit, University of Birmingham, Birmingham B15 2TT, UK; (J.K.); (P.B.)
- Correspondence:
| | - Jesse Kigozi
- Health Economics Unit, University of Birmingham, Birmingham B15 2TT, UK; (J.K.); (P.B.)
| | - Pelham Barton
- Health Economics Unit, University of Birmingham, Birmingham B15 2TT, UK; (J.K.); (P.B.)
| | - Julie Mytton
- Faculty of Health and Applied Sciences, University of the West of England, Bristol BS16 1QY, UK;
| |
Collapse
|
3
|
Sánchez González MP, Escribano Sotos F, Tejada Ponce Á. [Provincial savings of costs in road accidents in Spain (2000-2014)]. GACETA SANITARIA 2019; 34:553-560. [PMID: 31594678 DOI: 10.1016/j.gaceta.2019.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 04/25/2019] [Accepted: 05/02/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To quantify cost savings obtained before and after the implementation of the penalty-points driving licence on the interurban roads in Spain. METHOD Descriptive study through the construction of three indicators that expressed the cost savings by the number of victims avoided. We defined two periods according to the objective and collected data on fatalities, serious injuries and slight injuries on interurban roads in 1999-2014 for each Spanish province. Thus, data for its population, GDP or number of vehicles-kilometres travelled on its roads (MVKT) were used for each province. The quantification of savings was obtained using official figures of costs for each type of victim in 2014 prices. RESULTS The cost savings per inhabitant on fatalities in the period of validity of the penalty-points driving licence was between 3.89 and 19.65 per year. Savings on serious injuries by MVKT were reduced by 15%-66% between 2006 and 2014, being from 449.15 to 1707.88 annually. CONCLUSIONS During the period of validity of the penalty-points driving licence, the Spanish provinces have achieved significant cost savings.
Collapse
Affiliation(s)
| | - Francisco Escribano Sotos
- Facultad de Ciencias Económicas y Empresariales, Universidad de Castilla-La Mancha, Albacete, España
| | - Ángel Tejada Ponce
- Facultad de Ciencias Económicas y Empresariales, Universidad de Castilla-La Mancha, Albacete, España
| |
Collapse
|
4
|
Mueller N, Rojas-Rueda D, Basagaña X, Cirach M, Cole-Hunter T, Dadvand P, Donaire-Gonzalez D, Foraster M, Gascon M, Martinez D, Tonne C, Triguero-Mas M, Valentín A, Nieuwenhuijsen M. Health impacts related to urban and transport planning: A burden of disease assessment. ENVIRONMENT INTERNATIONAL 2017; 107:243-257. [PMID: 28778040 DOI: 10.1016/j.envint.2017.07.020] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 07/20/2017] [Accepted: 07/21/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Until now, estimates of the Global Burden of Disease (GBD) have mainly been produced on national or regional levels. These general estimates, however, are less useful for city governments who have to take decisions on local scales. To address this gap, we focused on the city-level burden of disease (BD) due to exposures affected by urban and transport planning. We conducted a BD assessment using the Urban and Transport Planning Health Impact Assessment (UTOPHIA) tool to estimate annual preventable morbidity and disability-adjusted life-years (DALYs) under compliance with international exposure recommendations for physical activity (PA), exposure to air pollution, noise, heat, and access to green spaces in Barcelona, Spain. METHODS Exposure estimates and morbidity data were available for 1,357,361 Barcelona residents ≥20years (2012). We compared recommended with current exposure levels to estimate the associated BD. We quantified associations between exposures and morbidities and calculated population attributable fractions to estimate the number of attributable cases. We calculated DALYs using GBD Study 2015 background DALY estimates for Spain, which were scaled to Barcelona considering differences in population size, age and sex structures. We also estimated annual health costs that could be avoided under compliance with exposure recommendations. RESULTS Not complying with recommended levels for PA, air pollution, noise, heat and access to green spaces was estimated to generate a large morbidity burden and resulted in 52,001 DALYs (95% CI: 42,866-61,136) in Barcelona each year (13% of all annual DALYs). From this BD 36% (i.e. 18,951 DALYs) was due to traffic noise with sleep disturbance and annoyance contributing largely (i.e. 10,548 DALYs). Non-compliance was estimated to result in direct health costs of 20.10 million € (95% CI: 15.36-24.83) annually. CONCLUSIONS Non-compliance of international exposure recommendations was estimated to result in a considerable BD and in substantial economic expenditure each year in Barcelona. Our findings suggest that (1) the reduction of motor traffic together with the promotion of active transport and (2) the provision of green infrastructure would result in a considerable BD avoided and substantial savings to the public health care system, as these measures can provide mitigation of noise, air pollution and heat as well as opportunities for PA promotion.
Collapse
Affiliation(s)
- Natalie Mueller
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - David Rojas-Rueda
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Xavier Basagaña
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Marta Cirach
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Tom Cole-Hunter
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Payam Dadvand
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - David Donaire-Gonzalez
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Physical Activity and Sports Sciences Department, Fundació Blanquerna, Barcelona, Spain
| | - Maria Foraster
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Mireia Gascon
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - David Martinez
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Cathryn Tonne
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Margarita Triguero-Mas
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Antònia Valentín
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mark Nieuwenhuijsen
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| |
Collapse
|
5
|
Latin American Clinical Epidemiology Network Series - Paper 6: The influence of alcohol in traffic accidents and health care costs of it in Bogotá-Colombia. J Clin Epidemiol 2016; 86:106-110. [PMID: 27771356 DOI: 10.1016/j.jclinepi.2016.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 11/22/2015] [Accepted: 10/10/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVES In Colombia, some studies have estimated medical costs associated to traffic accidents. It is required to assess results by city or region and determine the influence of variables such as alcohol consumption. The main objective of this study was to identify health care costs associated to traffic accidents in Bogota and determine whether alcohol consumption can increase them. STUDY DESIGN AND SETTING Cross-sectional costs study conducted in patients over 18 years treated in the emergency rooms of six different hospitals in Bogota, Colombia. RESULTS The average total cost of medical care per patient was 628 USD, in Bogota-Colombia. The average cost per accident was estimated at 1,349 USD. On average, the total cost for health care for patients with positive blood alcohol level was 1.8 times higher than those who did not consume alcohol. The indirect costs were on average 115.3 USD per injured person. Numbers are expressed in 2011 U.S. dollars. CONCLUSION Alcohol consumption increases the risk of traffic accidents and direct medical health costs.
Collapse
|
6
|
Velez-Jaramillo DA, Lugo-Agudelo LH, Cano-Restrepo BC, Castro-García PA, García-García HI. Costos de atención y rehabilitación de pacientes con lesiones por accidentes de tránsito en el mundo. REVISTA FACULTAD NACIONAL DE SALUD PÚBLICA 2016. [DOI: 10.17533/udea.rfnsp.v34n2a11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
7
|
Cubí-Mollá P, Peña-Longobardo LM, Casal B, Rivera B, Oliva-Moreno J. [Labor productivity losses attributable to premature deaths due to traffic injuries between 2002 and 2012]. GACETA SANITARIA 2015; 29 Suppl 1:79-84. [PMID: 26342411 DOI: 10.1016/j.gaceta.2015.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 03/02/2015] [Accepted: 03/11/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To estimate the years of potential life lost, years of potential productive life lost and the labor productivity losses attributable to premature deaths due to traffic injuries between 2002 and 2012 in Spain. METHOD Several statistical sources were combined (Spanish Registry of Deaths, Labor Force Survey and Wage Structure Survey) to develop a simulation model based on the human capital approach. This model allowed us to estimate the loss of labor productivity caused by premature deaths following traffic injuries from 2002 to 2012. In addition, mortality tables with life expectancy estimates were used to compute years of potential life lost and years of potential productive life lost. RESULTS The estimated loss of labour productivity caused by fatal traffic injuries between 2002 and 2012 in Spain amounted to 9,521 million euros (baseline year 2012). The aggregate number of years of potential life lost in the period amounted to 1,433,103, whereas the years of potential productive life lost amounted to 875,729. Throughout the period analyzed, labor productivity losses and years of life lost diminished substantially. CONCLUSIONS Labor productivity losses due to fatal traffic injuries decreased throughout the period analyzed. Nevertheless, the cumulative loss was alarmingly high. Estimation of the economic impact of health problems can complement conventional indicators of distinct dimensions and be used to support public policy making.
Collapse
Affiliation(s)
| | | | - Bruno Casal
- Departamento de Economía Aplicada I, Universidad de A Coruña, A Coruña, España
| | - Berta Rivera
- Departamento de Economía Aplicada I, Universidad de A Coruña, A Coruña, España
| | - Juan Oliva-Moreno
- Departamento de Análisis Económico y Finanzas, Universidad de Castilla-La Mancha, Toledo, España
| |
Collapse
|
8
|
Clèries M, Bosch A, Vela E, Bustins M. [Road traffic injuries in Catalonia (Spain): an approach using the minimum data set for acute-care hospitals and emergency resources]. GACETA SANITARIA 2015; 29 Suppl 1:36-42. [PMID: 26342410 DOI: 10.1016/j.gaceta.2015.03.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 03/18/2015] [Accepted: 03/18/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To verify the usefulness of the minimum data set (MDS) for acute-care hospitals and emergency resources for the study of road traffic injuries and to describe the use of health resources in Catalonia (Spain). METHODS The study population consisted of patients treated in any kind of emergency service and patients admitted for acute hospitalization in Catalonia in 2013. A descriptive analysis was performed by age, gender, time and clinical variables. RESULTS A total of 48,150 patients were treated in hospital emergency departments, 6,210 were attended in primary care, and 4,912 were admitted to hospital. There was a higher proportion of men (56.2%), mainly aged between 20 and 40 years. Men accounted for 54.9% of patients with minor injuries and 75.1% of those with severe injuries. Contusions are the most common injury (30.2%), followed by sprains (28.7%). Fractures mostly affected persons older than 64 years, internal injuries particularly affected men older than 64 years, and wounds mainly affected persons younger than 18 years and older than 64 years. In the adult population, the severity of the injuries increased with age, leading to longer length of stay and greater complexity. Hospital mortality was 0.2%. Fractures, internal injuries and wounds were more frequent in the group of very serious injuries, and sprains and contusions in the group of minor injuries. CONCLUSIONS MDS records (acute hospitals and emergency resources) provide information that is complementary to other sources of information on traffic accidents, increasing the completeness of the data.
Collapse
Affiliation(s)
| | - Anna Bosch
- Servei Català de la Salut, Barcelona, España
| | - Emili Vela
- Servei Català de la Salut, Barcelona, España
| | | |
Collapse
|
9
|
Gómez Restrepo C, Quitian H, Maldonado P, Naranjo-Lujan S, Rondón M, Acosta A, Arango-Villegas C, Hurtado J, Hernández JC, Angarita MDP, Peña M, Saavedra MÁ. Costos directos de atención médica de accidentes de tránsito en Bogotá D.C. Rev Salud Publica (Bogota) 2015. [DOI: 10.15446/rsap.v16n5.44080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
<p><strong>Objetivo </strong>Determinar los costos de atención médica generados por la accidentalidad vial en Bogotá.</p><p><strong>Metodología </strong>Estudio observacionalprospectivo con datos de pacientes mayores de edad atendidos en la central de urgencias de 6 instituciones hospitalarias.</p><p><strong>Resultados</strong>El promedio del costo totalde atenciónpor paciente fue de $1112000 El costo promedio día de paciente hospitalizado fue de $1200000. Pacientes con atención ambulatoria tuvieron un costo promedio de $247400. El costo promedio por accidente se calculó en $2333700. Los costos médicos por accidentes en el periodo de análisis en Bogotá fueron aproximadamente $2301028200. Cifras en pesos de 2011.</p><p><strong>Conclusiones</strong>Los costos de la atención médica de los accidentes de tránsito constituyen una carga económica considerable</p>
Collapse
|
10
|
Gómez-Restrepo C, Gómez-García MJ, Naranjo S, Rondón MA, Acosta-Hernández AL. Alcohol consumption as an incremental factor in health care costs for traffic accident victims: evidence in a medium sized Colombian city. ACCIDENT; ANALYSIS AND PREVENTION 2014; 73:269-273. [PMID: 25261620 DOI: 10.1016/j.aap.2014.09.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 08/06/2014] [Accepted: 09/19/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVES Identify the possibility that alcohol consumption represents an incremental factor in healthcare costs of patients involved in traffic accidents. METHODS Data of people admitted into three major health institutions from an intermediate city in Colombia was collected. Socio-demographic characteristics, health care costs and alcohol consumption levels by breath alcohol concentration (BrAC) methodology were identified. Generalized linear models were applied to investigate whether alcohol consumption acts as an incremental factor for healthcare costs. RESULTS The average cost of healthcare was 878 USD. In general, there are differences between health care costs for patients with positive blood alcohol level compared with those who had negative levels. Univariate analysis shows that the average cost of care can be 2.26 times higher (95% CI: 1.20-4.23), and after controlling for patient characteristics, alcohol consumption represents an incremental factor of almost 1.66 times (95% CI: 1.05-2.62). CONCLUSIONS Alcohol is identified as a possible factor associated with the increased use of direct health care resources. The estimates show the need to implement and enhance prevention programs against alcohol consumption among citizens, in order to mitigate the impact that traffic accidents have on their health status. The law enforcement to help reduce driving under the influence of alcoholic beverages could help to diminish the economic and social impacts of this problem.
Collapse
Affiliation(s)
- Carlos Gómez-Restrepo
- Department of Psychiatry and Mental Health and Director of the Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Pontificia Universidad Javeriana, Bogota, Colombia
| | - María Juliana Gómez-García
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Salomé Naranjo
- Universidad de Los Andes. Research Director of the Road Prevention Fund Corporation, Colombia
| | - Martín Alonso Rondón
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Pontificia Universidad Javeriana, Bogota, Colombia
| | | |
Collapse
|
11
|
Alemany R, Ayuso M, Guillén M. Impact of road traffic injuries on disability rates and long-term care costs in Spain. ACCIDENT; ANALYSIS AND PREVENTION 2013; 60:95-102. [PMID: 24036315 DOI: 10.1016/j.aap.2013.08.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Revised: 07/12/2013] [Accepted: 08/20/2013] [Indexed: 06/02/2023]
Abstract
Road traffic injuries are one of the leading causes of increasing disability-adjusted life expectancy. We analyze long-term care needs associated with motor vehicle crash-related disability in Spain and conclude that needs attributable traffic injuries are most prevalent during victims' mid-life years, they create a significant burden for both families and society as a whole given that public welfare programmes supporting these victims need to be maintained over a long time frame. High socio-economic costs of road traffic accidents (in Spain 0.04% of the GDP in 2008) are clearly indicative of the need for governments and policymakers to strengthen road accident preventive measures.
Collapse
Affiliation(s)
- Ramon Alemany
- Department of Econometrics, Riskcenter, University of Barcelona, Avda. Diagonal, 690, Barcelona 08034, Spain
| | | | | |
Collapse
|
12
|
García-Altés A, Suelves JM, Barbería E. Cost savings associated with 10 years of road safety policies in Catalonia, Spain. Bull World Health Organ 2012; 91:28-35. [PMID: 23397348 DOI: 10.2471/blt.12.110072] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Revised: 10/29/2012] [Accepted: 10/29/2012] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To determine whether the road safety policies introduced between 2000 and 2010 in Catalonia, Spain, which aimed primarily to reduce deaths from road traffic collisions by 50% by 2010, were associated with economic benefits to society. METHODS A cost analysis was performed from a societal perspective with a 10-year time horizon. It considered the costs of: hospital admissions; ambulance transport; autopsies; specialized health care; police, firefighter and roadside assistance; adapting to disability; and productivity lost due to institutionalization, death or sick leave of the injured or their caregivers; as well as material and administrative costs. Data were obtained from a Catalan hospital registry, the Catalan Traffic Service information system, insurance companies and other sources. All costs were calculated in euros (€) at 2011 values. FINDINGS A substantial reduction in deaths from road traffic collisions was observed between 2000 and 2010. Between 2001 and 2010, with the implementation of new road safety policies, there were 26 063 fewer road traffic collisions with victims than expected, 2909 fewer deaths (57%) and 25 444 fewer hospitalizations. The estimated total cost savings were around €18 000 million. Of these, around 97% resulted from reductions in lost productivity. Of the remaining cost savings, 63% were associated with specialized health care, 15% with adapting to disability and 8.1% with hospital care. CONCLUSION The road safety policies implemented in Catalonia in recent years were associated with a reduction in the number of deaths and injuries from traffic collisions and with substantial economic benefits to society.
Collapse
Affiliation(s)
- Anna García-Altés
- Catalan Agency for Health Information, Assessment and Quality, Roc Boronat 81-95 2nd floor, Barcelona 08005, Spain.
| | | | | |
Collapse
|
13
|
Kumar GA, Dilip TR, Dandona L, Dandona R. Burden of out-of-pocket expenditure for road traffic injuries in urban India. BMC Health Serv Res 2012; 12:285. [PMID: 22929107 PMCID: PMC3475104 DOI: 10.1186/1472-6963-12-285] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Accepted: 08/16/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Road traffic injuries (RTI) are an increasing public health problem in India where out-of-pocket (OOP) expenditures on health are among the highest in the world. We estimated the OOP expenses for RTI in a large city in India. METHODS Information on medical and non-medical expenditure was documented for RTI cases of all ages that reported alive or dead to the emergency departments of two public hospitals and a large private hospital in Hyderabad. Differential risk of catastrophic OOP total expenditure (COPE-T) and medical expenditure (COPE-M), and distress financing was assessed for 723 RTI cases that arrived alive at the study hospitals with multiple logistic regression. Catastrophic expenditure was defined as expenditure > 25% of the RTI patient's annual household income. Variation in intensity of COPE-M in RTI was assessed using multiple classification analysis (MCA). RESULTS The median OOP medical and non-medical expenditure was USD 169 and USD 163, respectively. The prevalence of COPE-M and COPE-T was 21.9% (95% CI 18.8-24.9) and 46% (95% CI 42-49.3), respectively. Only 22% had access to medical insurance. Being admitted to a private hospital (OR 5.2, 95% CI 2.7-9.9) and not having access to insurance (OR 3.8, 95% CI 1.9-7.6) were significantly associated with risk of having COPE - M. Similar results were seen for COPE - T. MCA analysis showed that the burden of OOP medical expenditure was mainly associated with in-patient days in hospital (Eta =0.191). Prevalence of distress financing was 69% (95% CI 65.5-72.3) with it being significantly higher for those reporting to the public hospitals (OR 2.8, 95% CI 1.7-4.6), those belonging to the lowest per capita annual household income quartile (OR 7.0, 95% CI 3.7-13.3), and for those without insurance access (OR 3.4, 95% CI 2.0-5.7). CONCLUSIONS This paper has outlined the high burden of out-of-pocket medical and total expenditure associated with RTI in India. These data reinforce the need for implementing more effective financial protection mechanisms in India against the high out-of-pocket expenditure incurred on RTI.
Collapse
Affiliation(s)
- G Anil Kumar
- Public Health Foundation of India, ISID Campus, 4, Institutional Area, Vasant Kunj, New Delhi 110 070, 1ndia
| | | | | | | |
Collapse
|