The identification and evaluation of medically impaired drivers is an important safety issue. The concept of medical fitness to drive is applicableto all ages but is particularly salient for older adults. Voluntary procedures to address medical fitness, whereby various professionals and familymembers may report concerns to State driver license bureaus, are common in the United States. This paper examines traffic crashes of drivers reported during 2001–2005 under the State of Missouri’s voluntary reporting law (House Bill HB-1536) and the resulting licensing outcomes. Missouri’s law is non-specific as to age, but the mean age of reported drivers was 80. Reports were submitted by police officers (30%), license office staff (27%),physicians (20%), family members (16%), and others (7%). The most common medical condition was dementia/cognitive (45%). Crash history for reporteddrivers was higher than that of controls, dating back to 1993, reaching apeak in 2001 when the share of reported drivers in crashes was 9.3% vs. 2.2% for controls—a fourfold difference. The crash share of reported drivers decreased rapidly after, indicating the impact of reporting, license revocation, and mortality. Of the 4,100 cases studied, 144 (3.5%) retained a valid driver’s license after the process.
Abstract