Analysis of Direct Medical Expenses Resulting from Road Traffic Injuries in the City of Tabriz

Document Type: Original Article

Authors

1 Department of Health Care Management, Tabriz Health Service Management Research Center, School of Management and Medical Information, Tabriz University of Medical Sciences

2 Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

Abstract

Background: Road crashes as a major global public health problem cost 3% of most countries and 5% of low‑ and middle‑income countries’
gross domestic product (GDP). The World Health Organization has predicted that without sustained action, road traffic crashes will become
the seventh leading cause of death by 2030. Objectives: The aim of this study was to analyze the death rate, severity of injuries, and direct
medical costs caused by road traffic injuries (RTI) in the city of Tabriz in 2014. Methods: Trauma injury admissions due to RTI in Imam
Reza Hospital in Tabriz City were investigated in terms of etiology and the direct medical costs during 2014–2015. Data were collected using
a researcher‑made checklist after being confirmed by relevant experts in terms of face validity. All information on direct medical costs are
extracted from several sources including hospitals, database of the Ministry of Health and Medical Education, disaster and emergency medical
management center, and public and private physiotherapy clinics across the city. Results: Review of the hospital records showed that the mean
age of the patients (67.9% males and 32.1% females) was 34 ± 17.3 years. In addition, 79.2% of the patients were treated on an outpatient
basis, and 20.8% were treated on a hospitalization basis (hospitalization or death). The mean times of inpatient and outpatient hospitalization
for injuries were 3 h and 6.7 ± 5.3 days, respectively. Total direct medical costs were 11.631 dollars, of which 8% was for hospital costs, 9.7%
for prehospital costs, and 2.3% for physiotherapy costs. Chest and lower part injuries had highest medical costs. From etiological standpoints,
the greatest reason of being injured and hospitalization is multiple injuries and bruises, and the prominent cause of death was blow to the head
and neck (70%). Conclusions: The results of the present study showed that direct medical costs in Tabriz during 2014–2015 were equal to
0.1% of GDP, which is a considerable amount. High economic and social costs of road accidents and their harmful physical and psychological
effects on individuals and community require the attention of professionals and experts in the transportation industry and health‑care system
to determine appropriate strategies for interventions in reducing accidents’ burden and injuries.

Keywords


1. World Health Organization. Global Status Report on Road Safety: Time
for Action. Geneva: World Health Organization; 2015.
2. Group World Bank. World Development Indicators 2014. World Bank
Publications; 2014.
3. Bhalla K, Diez‑Roux E, Taddia AP, De la Peña Mendoza SM, Pereyra A.
The Costs of Road Injuries in Latin America 2013. New York Ave, NW,
Washington DC: Inter‑American Development Bank; 2013.
4. Connelly LB, Supangan R. The economic costs of road traffic crashes:
Australia, states and territories. Accid Anal Prev 2006;38:1087‑93.
5. Zahed F, Rezaei AA. Calculation of external costs of road transportation
on social environment (with an emphasis on road accidents). Journal of
environmental science and technology fall 2006;8:35-42.
6. Elvik R. Analysis of official economic valuations of traffic accident
fatalities in 20 motorized countries. Accid Anal Prev 1995;27:237‑47.
7. Odero W, Garner P, Zwi A. Road traffic injuries in developing countries:
A comprehensive review of epidemiological studies. Trop Med Int
Health 1997;2:445‑60.
8. Riewpaiboon A, Piyauthakit P, Chaikledkaew U. Economic burden of 
road traffic injuries: A micro‑costing approach. Southeast Asian J Trop
Med Public Health 2008;39:1139‑49.
9. Rezaei S, Sari AA, Arab M, Ghasempour S. Economic burden
of road traffic crashes in Tehran province, Iran in 2009. Dir Gen
2013;10:1-12.
10. Hatami H, Razavi SM, Eftekhar Ardebili H, Bahador HA,
Nadim AH, Haydari K, et al. Comprehensive books public health.
Arjomand publication: Tehran 2009; Volume 11, Second edition: 1413-
1412.
11. Mahboub‑Ahari A, Pourreza A, Sari AA, Rahimi Foroushani A,
Heydari H. Stated time preferences for health: A systematic review
and meta analysis of private and social discount rates. J Res Health Sci
2014;14:181‑6.
12. Rezaei S. The Economic Burden of Road Traffic Crash (RTC) in Iran
in 2009 [MSc Thesis]. Tehran, Iran: School of Public Health, Tehran
University of Medical Sciences; 2011.
13. IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version
20.0. Armonk, NY: IBM Corp.
14. Mashreky SR, Rahman A, Khan TF, Faruque M, Svanström L,
Rahman F, et al. Hospital burden of road traffic injury: Major concern
in primary and secondary level hospitals in Bangladesh. Public Health
2010;124:185‑9.
15. Ayatollahi S, Hassanzadeh J, Ramezani A. The burden of traffic
accidents in South Khorasan province, Iran in 2005. Iran J Epidemiol
2009;4:51‑7.
16. Mohan D. The Road Ahead: Traffic Injuries and Fatalities in India
Delhi: Indian Institute of Technology, Transportation Research and
Injury Prevention Program; 2004.
17. Mohtasham‑Amiri Z, Dastgiri S, Davoudi‑Kiakalyeh A, Imani A,
Mollarahimi K. An epidemiological study of road traffic accidents
in Guilan province, Northern Iran in 2012. Bull Emerg Trauma
2016;4:230‑5.
18. Anh TT, Dao N, Anh T, editors. The cost of road traffic accident in
Vietnam. In: Proceedings of the Eastern Asia Society for Transportation
Studies. Japan: J‑Stage Tokyo; 2005.
19. Ditsuwan V, Veerman LJ, Barendregt JJ, Bertram M, Vos T. The national
burden of road traffic injuries in Thailand. Popul Health Metr 2011;9:2.
20. Bastida JL, Aguilar PS, González BD. The economic costs of traffic
accidents in Spain. J Trauma Acute Care Surg 2004;56:883‑9.
21. Yan‑Hong L, Rahim Y, Wei L, Gui‑Xiang S, Yan Y, De Ding Z, et al.
Pattern of traffic injuries in shanghai: Implications for control. Int J Inj
Contr Saf Promot 2006;13:217‑25.
22. Menon A, Pai VK, Rajeev A. Pattern of fatal head injuries due to
vehicular accidents in Mangalore. J Forensic Leg Med 2008;15:75‑7.
23. Bener A, Rahman YS, Mitra B. Incidence and severity of head and neck
injuries in victims of road traffic crashes: In an economically developed
country. Int Emerg Nurs 2009;17:52‑9.
24. Yates PJ, Williams WH, Harris A, Round A, Jenkins R. An epidemiological
study of head injuries in a UK population attending an emergency
department. J Neurol Neurosurg Psychiatry 2006;77:699‑701.
25. Toroyan T, Peden M. Youth and road safety. In Youth and road safety.
OMS 2007.
26. Yousefzadeh‑Chabok S, Haghdoust Z, Hemmati H. Road traffic
accidents, life‑threatening phenomenon in Guilan province: An
epidemiologic study. J Guilan Univ Med Sci 2015;23:1‑8.
27. Nazari R, Bijani A, Haji HF, Beheshti Z, Sharifnia S, Hojati H. Mortality
and injury severity in the accident victims referred to the Hefdah
Shahrivar Hospital of Amol. 2007 Journal of Babol University of
Medical Sciences 2011;13:76-81.
28. Dissanayake S, Lu JJ. Factors influential in making an injury severity
difference to older drivers involved in fixed object‑passenger car
crashes. Accid Anal Prev 2002;34:609‑18.
29. Foroudni F, Janghorbani M. Characteristics of the inner city road
traffic casualties in Kerman during 1994. J Kerman Univ Med Sci
1996;3:35‑42.
30. García‑Altés A, Pérez K. The economic cost of road traffic crashes in an
urban setting. Inj Prev 2007;13:65‑8.
31. Shahla A, Charehsaz S. Injuries resulting from motorcycle‑induced
trauma during two years in Shahid Motahari Clinical Center of
URMIA. Scientific journal of forensic medicine summer 2006 ;12:79-83.