Tyler Miller

Incidence and lifetime costs of injuries in the United States

Background: Standardized methodologies for assessing economic burden of injury at the national or international level do not exist. Objective: To measure national incidence, medical costs, and productivity losses of medically treated injuries using the most recent data available in the United States, as a case study for similarly developed countries undertaking economic burden analyses. Method: The authors combined several data sets to estimate the incidence of fatal and non-fatal injuries in 2000. They computed unit medical and productivity costs and multiplied these costs by corresponding incidence estimates to yield total lifetime costs of injuries occurring in 2000. Main outcome measures: Incidence, medical costs, productivity losses, and total costs for injuries stratified by age group, sex, and mechanism. Results: More than 50 million Americans experienced a medically treated injury in 2000, resulting in lifetime costs of

The Potential Impact of Poison Control Centers on Rural Hospitalization Rates for Poisoning

406 billion;

Implementing Red Light Camera Programs: Guidance from Economic Analysis of Safety Benefits

80 billion for medical treatment and

Potential consequences of replacing a retail alcohol monopoly with a private licence system: results from Sweden.

326 billion for lost productivity. Males had a 20% higher rate of injury than females. Injuries resulting from falls or being struck by/against an object accounted for more than 44% of injuries. The rate of medically treated injuries declined by 15% from 1985 to 2000 in the US. For those aged 0–44, the incidence rate of injuries declined by more than 20%; while persons aged 75 and older experienced a 20% increase. Conclusions: These national burden estimates provide unequivocal evidence of the large health and financial burden of injuries. This study can serve as a template for other countries or be used in intercountry comparisons.

The employer costs of motor vehicle crashes.

OBJECTIVE. This study tested the hypothesis that underutilization of poison control centers is associated with increased rates of hospitalizations attributable to poisonings in rural areas. METHODS. To measure the potential impact of poison control centers on hospitalization rates in rural areas among people who visit emergency departments because of poisoning, we estimated the reduction in hospitalization rates associated with increased rates of calls to centers. We used the 2003 State Inpatient Database and State Emergency Department Database from the Healthcare Cost and Utilization Project to calculate the numbers of emergency department visits and hospitalizations for each county in the 12 states analyzed. We used Toxic Exposure Surveillance System data from the American Association of Poison Control Centers to calculate the number of human exposure calls per capita according to county. RESULTS. In rural counties, a 1% higher poison control center human poison exposure call rate was associated with a 0.19% lower hospitalization rate among people who visited emergency departments because of poisoning. If the observed association is causative, then 43.3 calls would prevent 1 hospital admission, yielding

Review: Risk Compensation Literature — The Theory and Evidence

7321 in net cost savings and a return on investment of 5.9:1 (from the health care system perspective). CONCLUSIONS. Our results establish the existence of the hypothesized association between rural poison control center utilization rates and hospitalization rates among emergency department-treated poisoning patients.

Costs of Occupational Injuries in Construction in the United States

Red light camera (RLC) systems are believed to decrease the right-angle crashes that they are targeting but to have the undesirable side effect of increasing rear-end crashes. This belief was confirmed in a before-after study of 132 RLC installations in seven U.S. jurisdictions, as reported in a companion paper. In that research, the extent to which the increase in rear-end crashes negates the benefits for right-angle crashes was unclear, given the perceptions of severity differences in the two crash types. This paper reports on an examination of the changes in crash costs, based on a consideration of rear-end and right-angle unit crash costs for various severity levels, to establish the aggregate effects of the RLC programs evaluated. Part of the project derived the required unit costs by using information from national U.S. databases. The overall results show a modest to moderate economic benefit of between

Retail alcohol monopolies, underage drinking, and youth impaired driving deaths

28,000 and

Occupational injury costs and alternative employment in construction trades.

50,000 per treated site year, depending on assumptions made. The ability to aggregate economic costs across crash types and severity created the opportunity to try to isolate program implementation factors and intersection characteristics that would favor the installation of RLC systems by using the aggregate economic benefit at each RLC site as the outcome variable. This investigation found, for example, that the greatest economic benefits are associated with the highest total entering annual average daily traffic, the largest ratios of right-angle to rear-end crashes, and the presence of protected left-turn phases.

Substance-use problems: are uninsured workers at greater risk?

AIM To examine the potential effects of replacing the Swedish alcohol retail system with a private licensing system on alcohol consumption and alcohol-related harm. DESIGN Two possible scenarios were analysed: (1) replacing the current alcohol retail monopoly with private licensed stores that specialize in alcohol sales or (2) making all alcohol available in grocery stores. We utilized a multiplicative model that projected effects of changes in a set of key factors including hours of sale, retail prices, promotion and advertising and outlet density. Next, we estimated the effect of the projected consumption increase on a set of harm indicators. Values for the model parameters were obtained from the research literature. MEASUREMENTS Measures of alcohol-related harm included explicitly alcohol-related mortality, accident mortality, suicide, homicide, assaults, drinking driving and sickness absence. FINDINGS According to the projections, scenario 1 yields a consumption increase of 17% (1.4 litres/capita), which in turn would cause an additional 770 deaths, 8500 assaults, 2700 drinking driving offences and 4.5 million sick days per year. The corresponding figures for scenario 2 are a consumption increase of 37.4% (3.1 litres/capita) leading to an additional annual toll of 2000 deaths, 20 000 assaults, 6600 drinking driving offences and 11.1 million days of sick leave. CONCLUSIONS Projections based on the research literature suggest that privatization of the Swedish alcohol retail market would significantly increase alcohol consumption and alcohol-related harm.