motorcycle related crash victims and their associates hospital charges in illinois mehdi nassirpour...

Motorcycle Related Crash Victims and Their

Associates Hospital Charges in Illinois

Mehdi NassirpourWei Wu

Illinois Department of Transportation Division of Transportation Safety

Presented at the International Forum on Traffic Records & Information Systems in St. Louis, MO

Objectives

Overview of the Traffic Safety Programs Overview of Facts on Motorcycles Limitations of Crash Data Data Linkage Programs (CODES) Motorcycle Related injuries and Cost Results and Policy Implications Future Plans


Illinois Highway Safety Program Areas

Occupant Protection Impaired Driving Speed Control Traffic Records Emergency Medical

Services Pedestrian/Bicycle Motorcycle Safety Large Truck Police Traffic

Services Distracted Driving

We are required to identify those programs most effective in reducing crashes, injuries, and deaths, and eligible use of highway safety funds awarded to the State of Illinois


Highlights of Activities and Accomplishments

Coordinated with other highway safety programs during major safety campaigns (CIOT, YD&DYL, and Drive Sober or Get Pulled Over.

Student training has increased from 16,701 in 2009 to 20,361 in 2012, an increase of 21.9% annually.

Educational outreach has increased through educational/promotional events from 3 per year to 15 events in 2013.

Produced and aired first public informational videos for television in 2010 - 2013.

Developed and went online with www.STARTSEEINGMOTORCYCLES.org web site.

Developed and distributed a new “START SEEING MOTORCYLES” and “DON’T DRINK AND RIDE” poster for distribution at various locations statewide.


http://www.startseeingmotorcycles.org/

What We Know about Motorcycles

Motorcyclists have high death rates

Motorcycle deaths are increasing

Motorcycles are becoming popular

About 50% of motorcycle driver deaths involved in Single vehicle crashes

Demographics--average age of riders is going up (37)

Engine size is increasing—The higher the engine size, the higher the probability of being fatally injured


What We Know about Motorcycles Rider Characteristics differ by types of

motorcycles Alcohol use is a problem among

motorcyclists Supersport motorcycles have the highest

overall collisions Motorcycles don’t have safety gear that is

comparable to what we found in passenger cars

Rider safety training and education tend to reduce motorcycle related crashes (based on anecdotal information) Presented at the International Forum on Traffic Records & Information Systems in St. Louis, MO

Helmet Laws Laws requiring all motorcyclists to wear a

helmet are in place in 19 states (Universal Helmet Law).

Laws requiring only some motorcyclists (most often age 17 and under) to wear a helmet are in place in 28 states.

Two states (Florida and Michigan) allow motorcyclists over the age of 21 to ride without helmet if they have a certain level of medical insurance (over $10,000 or $20,000).

There is no motorcycle helmet use law in 3 states (Illinois, Iowa, and New Hampshire).


Motorcyclist Fatalities

2004 2005 2006 2007 2008 2009 2010 2011 2012 20130

200

400

600

800

1000

1200

1400

1600

157 158 132 157 135 130 131 145 148 155

1355 13631254 1248

1043911 927 918 956 991

Motorcycle Fatality Total Fatality


Change in Composition of Fatalities

73.2%

2.5%

9.8%

14.4%

2003

Passenger vehicle occupants

Large trucks, buses & other vehicle occupants

Motorcyclists

Peds, bicyclists & other non-occupants

65.6%3.2%

15.3%

15.8%

2013


Registered Motorcycles in Illinois by Year

20

04

20

05

20

06

20

07

20

08

20

09

20

10

20

11

20

12

20

13

0.0

50,000.0

100,000.0

150,000.0

200,000.0

250,000.0

300,000.0

350,000.0

400,000.02

62

,83

3

27

2,1

80

27

7,8

36

30

3,0

03

32

2,9

45

36

5,4

48

34

6,4

10

34

9,9

28

35

6,4

46

36

0,8

83


Motorcycle Fatalities and Fatality Rate Per 100,000 Registered Motorcycles, by Year

(Illinois)2

00

4

20

05

20

06

20

07

20

08

20

09

20

10

20

11

20

12

20

13

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

0

20

40

60

80

100

120

140

160

180157 158

132

157

135 130 131145 148 155

Fatality Fatality Rate


Motorcycle Fatalities and Fatality Rate Per 100,000 Registered Motorcycles, by Year

(US)2

00

4

20

05

20

06

20

07

20

08

20

09

20

10

20

11

20

12

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

0

1000

2000

3000

4000

5000

6000

Fatality Fatality Rate


Percent No Valid Motorcycle License Among Motorcycle Riders Involved in Fatal Crashes by

Year (Illinois Versus US)

2004 2005 2006 2007 2008 2009 2010 2011 20120.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

16.8%

20.8%

26.3%

19.9%

16.5% 17.1%

8.3%9.3% 8.8%

20.8% 20.9%

22.4%

24.0%22.0%

19.4% 18.7%

22.1%20.8%

% No Valid Lic. (Illinois) % No Valid Lic. (US)


Total Motorcycle Fatalities and Licensed Motorcyclists by Age (2010-

2012)

16 - 20

21 - 25

26 - 30

31 - 35

36 - 40

41 - 45

46 - 50

51 - 55

56 - 60

61+0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

16.0%

18.0%

3.8%

12.5%

10.4%

9.0%

10.8%

8.5%

11.3% 13.4%

9.4%

10.8%

1.6%

4.8%

6.7%7.7%

10.0%

11.9%

14.8%15.4%

12.4% 14.7%

% Fatlities % licensed MotorcyclistsPresented at the International Forum on Traffic

Records & Information Systems in St. Louis, MO

Percent Helmeted Motorcyclists who died in Motor Vehicle Crashes by Age

(2010-2012)

16 - 20

21 - 25

26 - 30

31 - 35

36 - 40

41 - 45

46 - 50

51 - 55

56 - 60

61+0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

50.0%43.8%

20.8%

25.0%

28.9%

10.9%

13.9%16.7%

12.3%

17.5%

32.6%

% Helmeted MootrcyclistPresented at the International Forum on Traffic

Records & Information Systems in St. Louis, MO

Motorcycle Fatalities, Total Injuries, and A-Injuries by Age Group (2010-2012)

Ages 0 to 15 Ages 16 to 20 Ages 21 to 34 Ages 35 to 44 Ages 45 to 64 Ages 65+0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

0.2% 2.

7%

35.0

%

19.5

%

37.9

%

4.7%

1.2%

6.9%

33.5

%

22.0

%

33.4

%

3.0%

1.1%

5.7%

29.7

%

24.4

%

36.2

%

2.9%

Fatalities Total Injuries A-Injuries


Motorcycle Fatalities, Total Injuries, and A-Injuries by 23 County Model Location (2010-

2012)

County is in 23 County Model County is not in 23 County model0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

67.0%

33.0%

75.7%

24.3%

69.4%

29.6%



Percent Fatalities by BAC Test in 2012

0.00 BAC 0.01 to 0.07 0.08 and greater No test given Test Performed, Results Unknown

0.0%5.0%

10.0%15.0%20.0%25.0%30.0%35.0%40.0%45.0%50.0%55.0%

48.3%

5.2%

32.0%

8.2%3.4%



Motorcycle Fatalities, Total Injuries, and A-Injuries by Time of Day (2010-2012)

3AM to 6AM 6AM to 9AM 9AM to NOON NOON to 3PM 3PM to 6PM 6PM to 9PM 9PM to MIDNIGHT

MIDNIGHT to 3AM-5.0%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

4.7%

4.7%

9.1%

14.5

%

24.1

%

21.9

%

11.8

%

9.1%

2.3%

5.9%

9.7%

20.5

%

25.5

%

19.5

%

11.0

%

5.7%

2.8% 4.

7%

9.6%

20.1

%

24.9

%

20.0

%

11.5

%

6.4%


Motorcycle Helmet Use for Fatalities, Total Injuries, and A-Injuries by Time of Day (2010-2012)

3AM to 6AM 6AM to 9AM 9AM to NOON NOON to 3PM 3PM to 6PM 6PM to 9PM 9PM to MIDNIGHT

MIDNIGHT to 3AM

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%45.0%

5.3%

10.5%

29.7%

28.8%

25.5%

24.7%

4.2%

5.4%

31.8%

42.8%37.8%

30.2% 28.5%31.9%

13.1%

23.7%25.0%

39.1%32.3%

27.8%

25.3%

25.5%

10.6%

19.7%



Illinois Data Linkage Project (Crash Outcome Data Evaluation System)


What is CODES?

Crash Outcome Data Evaluation System CODES evolved from the (Intermodal

Surface Transportation Efficiency Act of 1991 (ISTEA 1991)--ISTEA mandated that National Highway Traffic Safety Administration (NHTSA) to prepare a report to Congress about the benefits of safety belt and helmet use.

NHTSA sponsored the CODES projects and awarded grants to several states to link their databases.


CODES (Data Linkages) Provide funding to states to link their existing

traffic-safety related databases Injuries resulting from motor vehicle crashes

is a major public health problem. Injuries can be prevented, or reduced, if we

understand their type, severity and cost. Crash data alone do not indicate the injury

problem in terms of the medical and financial consequences.

By linking crash data to their specific medical and financial outcomes, we can identify prevention factors.


Strategy Link crash report records to medical

treatment records in a computer database to learn the full story


Data Linkage ModelBayesian Statistical Theory—The

main objective of this theory is to calculate the probability of an uncertain claim in light of prior information and new experimental evidence.


CODES2000/Linksolve Linkage Software

• It is developed by Strategic Matching , Inc. that had contract with NHTSA.

• It is a probabilistic records Linkage Software that includes effective algorithms for data preparation, analysis, and comparison.


Benefits of Linked Data

Linked data can be disaggregated to provide information to local communities.

Linkage enhances the value of each state data file being linked by expanding the comprehensiveness of each state data set.

Linkage provides access to more detailed medical information for highway and traffic safety evaluation; and linkage provides more detailed safety information for injury control purposes.


Benefits of Linked Data

Collaboration of traffic safety and health care communities

The linked data can be used by multiple users for different purposes.

The linked data process results in increased data quality.

Linking data encourages standardized and computerization of state data.Presented at the International Forum on Traffic Records & Information Systems in St. Louis, MO

Linked Data Process in (2010-2011)

Hospital Inpatient and Emergency Department (ED) Database

Crash

Total Crash Victim= 1,323,842

Linked Total=105,828 Outpatient =98,829Inpatient=6,999


Total Hospital Records= 2,454,006

Frequency and Percentage Distribution of All Crashes and Motorcycle Crashes

All Crash persons

Motorcycle Occupants

Individuals involved in Crash

Frequency

Percent Frequency

Percent

Total hospital discharge data used for the linkage

2,454,006 100.0%

- -Total inpatient discharge records

192,238 7.83%- -

Total outpatient discharge records

2,261,768 92.2%- -

Total number of individuals involved in crashes

1,323,842 100.0% 8,647 100.0%

Linked hospital inpatients

7,000 0.53% 1,102 12.7%

Linked hospital Outpatient

98,828 7.5% 3,331 38.5%

Linked crash individuals (in & out)

105,828 8.0% 4,433 51.3%

Not linked crash individuals

1,218,014 92.0% 4,214 48.7%Presented at the International Forum on Traffic Records & Information Systems in St. Louis, MO

Percent Total Inpatient and Outpatient Motorcycle Occupants by Gender

Male Female0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%82.8%

17.2%

85.1%

14.9%

82.0%

18.0%

Total Inpatient Outpatient



Percent Total Inpatient and Outpatient Motorcycle Occupants by Age Group

Ages 0 to 15 Ages 16 to 20 Ages 21 to 34 Ages 35 to 44 Ages 45 to 64 Ages 65+0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

1.0%

6.2%

31.8

%

20.6

%

36.6

%

3.8%

0.5%

4.6%

29.9

%

22.1

%

37.2

%

5.6%

1.2%

6.7%

32.4

%

20.1

%

36.4

%

3.2%

Total Inpatient Outpatient


Motorcycle Fatalities, Total Injuries, and A-Injuries by Age Group (2010-2011)

Ages 0 to 15 Ages 16 to 20 Ages 21 to 34 Ages 35 to 44 Ages 45 to 64 Ages 65+0.0%5.0%

10.0%15.0%20.0%25.0%30.0%35.0%40.0%45.0%50.0%

0.7%

4.4%

29.9

%

14.6

%

44.1

%

6.3%

1.0%

6.1%

31.4

%

20.6

%

37.0

%

3.9%

0.8%

5.4%

28.0

%

21.5

%

40.3

%

3.9%


Helmet Use by Age

Age 0 to 15

Age 16 to 20

Age 21 to 24

Age 25 to 34

Age 35 to 44

Age 45 to 54

Age 55 to 64

Age 65 to 74

Age 75 & Over

30.00%

35.00%

40.00%

45.00%

50.00%

55.00%

60.00%

65.00%

70.00%

60.22%

49.85% 49.70% 49.07%

45.50%

42.68%

48.48%

60.22%

67.21%

52.47%

45.94%

43.81%

41.55%

38.38%37.09%

44.04%

56.81%

58.77%

All People Involved Linked Injury


Frequency and Percentage Distributions of Linked Motorcycle Occupants By

Helmet Status

Helmeted Not Helmete

d

Miscoded/Not

Available

Inpatient Discharge

393(35.7%)

706(64.1%)

3(0.2%)

Outpatient Discharge (ED)

1442(43.3%)

1872(56.2%)

16(0.5%)

Total Hospital Discharge

1835(41.4%)

2578(58.2%)

19(0.4%)


Percent Head Injuries by Helmet Status

Helmeted Not Helmeted0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

12.3%

22.9%

Total helmeted with head injury =225Total helmeted with no head injury=1610

Total Not helmeted with head injury =590Total Not helmeted with no head injury=1988

Note: the relationship between Helmet use and head injury is significant. Odd Ratio (OR) value is over 0.34 indicates that wearing helmet a protective against head injury.


Frequency and Percentage Distributions of Helmet Use and Head

Injury

Helmet UseNo

Injury Minor

Moderat

e Serious Severe Critical

No Helmet 2005 150 169 68 162 43

%77.20% 5.78% 6.51% 2.62% 6.24% 1.66%

Helmeted1610 37 93 31 52 12

%87.74% 2.02% 5.07% 1.69% 2.83% 0.65%

All3615 187 261 99 214 55

%81.58% 4.22% 5.89% 2.23% 4.83% 1.24%


Average Hospital Charge Per Discharge

All Crash Victims

Motorcycle Occupants

Inpatient Discharge

$68,659 $86,703

Outpatient Discharge (ED)

$4,407 $7,576

Total Hospital Discharge

$8,657 $27,248


Average Hospital Charge by Age

Age 0 to 15

Age 16 to 20

Age 21 to 24

Age 25 to 34

Age 35 to 44

Age 45 to 54

Age 55 to 64

Age 65 to 74

Age 75 & Over

$0

$20,000

$40,000

$60,000

$80,000

$100,000

$120,000

$42,356

$98,584

$78,475

$89,154 $87,428$82,933

$97,206

$76,403

$44,997

$5,608$7,097 $7,224 $7,228 $7,772 $7,803 $8,240 $7,443 $5,693

$10,387

$23,962$21,378

$27,920 $28,967$26,455

$31,405 $32,200

$22,932

Inpatient Outpatient All


Average Hospital Charge Per Discharge (Mean)

Helmeted

Not Helmete

d

Percent Differenc

e

Inpatient Discharge $86,644 $86,737 0.11%Outpatient Discharge (ED) $6,936 $8,065 16.28%Total Hospital Discharge $24,015 $29,532 22.97%


Average Hospital Charge Per Discharge (Median)

Helmeted

Not Helmete

d

Percent Differenc

e

Inpatient Discharge $44,928 $45,505 1.28%Outpatient Discharge (ED) $3,931 $5,246 33.44%Total Hospital Discharge $6,028 $9,015 49.56%


Mean Charges by Gender

Female Male$0

$10,000

$20,000

$30,000

$40,000

$50,000

$60,000

$70,000

$80,000

$90,000

$100,000

$84,450 $87,042

$7,763 $7,537

$23,208$28,024

Mean Charges (Inp) Mean Charges (Out) Mean Charges (All)


Research Questions

What variables predict a head injury?

What Variables Predict Hospital Charges


Definition of Selected Variables


Variables Definition Gender Dummy variable with a value of 1 for male occupants and 0 for female occupants

Age Self-explanatoryOccupant Type Dummy variable with a value of 1 for operator and 0 for passenger Time of Day Dummy variable with a value of 1 for occupants involved in nighttime crashes

(6:00PM – 5:59AM) and 0 for occupants involved in daytime crashes (6:00AM – 5:59PM)

Day of Week Dummy variable with a value of 1 for occupants involved in weekend crashes and 0 for occupants involved in weekday crashes

Crash Location Dummy variable with a value of 1 for occupants involved in crashes on rural roads and 0 for occupants involved in crashes on other roads

Alcohol Involvement

Dummy variable with a value of 1 for occupants involved in alcohol related crashes and 0 for all other occupants

Helmet Use Dummy variable with a value of 1 for occupants wore helmet in crashes and 0 for all unprotected occupants involved in crashes

Injury location Dummy variable with a value of 1 for occupants experienced head injury from crashes and 0 for all other occupants who do not have head injury from crashes.

Intersection Related

Dummy variable with a value of 1 for occupants who are involved in Intersection-related crashes and 0 for all other occupants who are not involved in intersection-related crashes

Hospital Charges Total hospital charge per discharge

Result of Logistic Regression Analysis on Head Injury

SELECTED VARIABLES EstimateStd

ErrorChi

Square P-value Odd Ratio

Intercept -2.2045 0.0850 672.5434 <.0001

HELMET STATUS (HELMETED=1) -0.6540 0.1026 -6.38 <.0001 0.519

ALCOHOL IMPAIRMENT (IMPAIRED=1) 0.6884 0.1094 6.29 <.0001 1.237

GENDER (MALE=1) 0.2127 0.1646 1.29 0.1967 1.237

AGE 0.0093 0.0029 3.17 0.0015 1.009

RURAL/URBAN (RURAL=1) -0.0124 0.0949 -0.13 0.8959 0.990

TIME OF CRASH (Night=1) 0.2952 0.0869 3.4 0.0007 1.047

DAY OF WEEK (WEENKEND=1) 0.0476 0.0853 0.56 0.5771 1.127

OPERATOR/PASSENGER (OPERATOR=1) 0.1164 0.2125 0.55 0.5846 0.840

INTERSECTION-RELATED (INTERSECTION=1) -0.1742 0.0877 -1.98 0.0473 1.066

SPEED RELATED (SPEED=1) 0.0617 0.0963 0.64 0.524 1.749


Results of Regression Analysis on Hospital Charges

SELECTED VARIABLES EstimateStd

Error t Value Pr > |t|

Intercept 8.385294647 0.04118056

203.62 <.0001

HELMET STATUS (HELMETED=1) -0.117429630

0.01826189

-6.43 <.0001

ALCOHOL IMPAIRMENT (IMPAIRED=1)

0.253635155 0.02833548

8.95 <.0001

GENDER (MALE=1) -0.125676045

0.03295624

-3.81 0.0001

AGE 0.007631491 0.00064118

11.90 <.0001

RURAL/URBAN (RURAL=1) -0.078932129

0.01999662

-3.95 <.0001

TIME OF CRASH (Night=1) 0.056650762 0.01925361

2.94 0.0033

DAY OF WEEK (WEENKEND=1) 0.011761866 0.01812550

0.65 0.5164

OPERATOR/PASSENGER (OPERATOR=1)

0.264075735 0.04015645

6.58 <.0001

HEAD/NO HEAD INJURY (HEAD INJURY=1)

0.483135120 0.00781381

61.83 <.0001

INTERSECT RELATED (INTERSECTION=1)

-0.116574196

0.01882384

-6.19 <.0001

SPEED RELATED (SPEED=1) 0.140418178 0.01897580

7.40 <.0001


Definition of Serious Injury

The FHWA recommends “serious injuries” as “`suspected serious injury' (A)” as identified in the latest edition of the MMUCC. The MMUCC definition of a suspected serious injury (A) is any injury, other than fatal, which results in one or more of the following:1. Severe laceration resulting in exposure of underlying tissues,

muscle, organs, or resulting in significant loss of blood;2. Broken or distorted extremity (arm or leg);3. Crush injuries;4. Suspected skull, chest, or abdominal injury other than bruises or

minor lacerations;5. Significant burns (second and third degree burns over 10 percent or

more of the body);6. Unconsciousness when taken from the crash scene; or7. Paralysis.(Illinois Definition: severe lacerations, broken limbs, skull or chest injuries, and abdominal injuries)


Problem with Definition of Serious Injury

The DOT also recognizes that as serious injury data is migrated to the MMUCC definition, variances may occur in the data collected and reported by States and that States should make necessary adjustments in establishing targets to accommodate these changes.


Proposed Solution

Finally, in section 490.207(d), the FHWA recommends, but would not require, that States prepare themselves so that no later than calendar year 2020, serious injuries data is collected through and reported by a hospital records injury outcome reporting system that links injury outcomes from hospital inpatient and emergency discharge databases to crash reports. An example of a crash outcome data linkage system is the NHTSA Crash Outcome Data Evaluation System (CODES).


Comparing KABCO to MAIS Categories

Max AIS Score by Crash Severity Level for Year 2010-2011

Max AIS Property

Damaged Only Mild Moderate Incapacitated Killed Total

Scores N % N % N % N % N % N %

No Injury 1 0.5% 4 1.9% 23 1.0% 14 0.8% 13 9.5% 55 1.2%

Mild 136 66.7% 154 67.0% 1267 58.4% 524 31.0% 24 17.9% 2105 47.5%

Moderate 53 25.9% 59 25.5% 648 29.9% 609 36.0% 23 16.7% 1391 31.4%

Serious 7 3.3% 7 3.2% 150 6.9% 325 19.2% 27 19.8% 516 11.6%Severe 6 3.0% 5 2.3% 75 3.5% 197 11.6% 12 8.6% 295 6.7%Critical 1 0.7% 0 0.0% 7 0.3% 24 1.4% 37 26.8% 69 1.6%

Maximum 0 0.0% 0 0.0% 0 0.0% 1 0.1% 1 0.7% 2 0.0%

All 203 100.0% 230 100.0% 2169 100.0% 1694 100.0% 137 100.0% 4433 100.0%


Future Plan

Complete the analysis of the linked data

Develop a comprehensive profile of Motorcyclists who injured in motor vehicle crashes using 2012 data

Produce Fact Sheets and reports on several traffic safety issues


Contact Information Mehdi NassirpourWei WuDivision of Traffic Safety at IDOT1340 North 9th Springfield, IL 62702Email: [email protected]

DTS’ Evaluation Website:http://www.dot.il.gov/trafficsafety/tsevaluation.html

Contact Information Mehdi NassirpourWei WuDivision of Traffic Safety at IDOT1340 North 9th Springfield, IL 62702Email: [email protected]

DTS’ Evaluation Website:http://www.dot.il.gov/trafficsafety/tsevaluation.html


http://www.dot.il.gov/trafficsafety/tsevaluation.html

http://www.dot.il.gov/trafficsafety/tsevaluation.html

motorcycle related crash victims and their associates hospital charges in illinois mehdi nassirpour...

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