INTRACRANIAL INJURY AND MORTALITY ASSOCIATED WITH MOTORCYCLE-RELATED HOSPITALIZATIONS: DIFFERENCES IN INCIDENCE AND COSTS ON THE BASIS OF UNIVERSAL MOTORCYCLE HELMET USE LEGISLATION IN THE UNITED STATES Público
Parker, Brenda Marie (2011)
Abstract
Intracranial Injury and Mortality Associated with
Motorcycle-related Hospitalizations: Differences in Incidence and
Costs on the Basis of Universal
Motorcycle Helmet Use Legislation in the United States
Objectives: To compare the incidence of intracranial injury and
in-hospital mortality as well as costs associated with
motorcycle-related hospitalizations on the basis of universal
motorcycle helmet legislation in the United States.
Methods: A retrospective cross-sectional ecological database
analysis was performed using all hospitalizations with a
supplementary classification of external causes of injury and
poisoning code for motorcycle-related crashes from the Healthcare
Cost and Utilization Project Nationwide Inpatient Sample for the
years 2005 to 2007. Differences in intracranial injury and
mortality rates as well as costs were compared between two groups
defined by the presence or absence of universal motorcycle helmet
use legislation in the US.
Results: Over the analysis period, there were 87,616
injury-related hospital discharges as a result of
motorcycle-related crashes. In the absence of universal motorcycle
helmet use legislation, intracranial injury and in-hospital
mortality was 20% and nearly four times more likely to occur,
respectively, than in its presence (OR 1.20; 95% CI 1.022-1.418 and
OR 3.825; 95% CI 3.061-4.781, respectively). Mean costs associated
with hospitalization were higher in the presence of universal
legislation than where it was absent, $60,478 and $23,243,
respectively (p<0.0018).
Conclusions: Additional research and advocacy of other public
health models and injury prevention strategies to complement
motorcycle helmet use legislation is warranted to increase the
likelihood that Congress may uphold any future legislation that
encourages state adoption of universal motorcycle helmet use
legislation as persuasion of state legislatures to maintain or
re-enact such legislation based on fact alone has, to-date, proven
futile.
Table of Contents
Distribution Agreement Abstract Acknowledgements Introduction Problem Statement Purpose Statement Research Questions and Hypotheses Significance Statement Definition of Terms Review of the Literature Methods Overview Patient Selection Data Source Study Measures Data Analysis Results Conclusions and Discussion Tables Table 1. Medical Subject Headings (MeSH) Classification and Terms Table 2. Study Population Demographics Table 3. Study Population Clinical Characteristics Table 4. Demographics According to Motorcycle Helmet Use Legislation Table 5. Clinical Characteristics According to Motorcycle Helmet Use Legislation Table 6. Tests of Association for Intracranial Injury, In-hospital Mortality and Costs Table 7. Final Regression Model Parameters for Intracranial Injury Table 8. Final Regression Model Parameters for In-hospital Mortality Table 9. Final Regression Model Parameters for Costs Appendices Appendix 1. External Causes of Injury and Poisoning Codes (ECodes) For Motorcycle-Related Crashes References
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