Despite harsh legislation, driving under the influence of alcohol (DUI) is exceedingly common, and alcohol-related motor vehicle crashes (MVCs) account for significant morbidity, mortality, and economic loss. Legal sanctions can keep offenders off the road (protecting other drivers and pedestrians) and ensure compliance with treatment programs (reducing recidivism). However, even with clear evidence of a transgression, the law seems to be inconsistently enforced among trauma patients. The purpose of this study was to measure the rate of legal prosecution among impaired drivers admitted to a trauma center after MVCs, and to determine the recidivism rate among these individuals. Our trauma registry was queried to identify intoxicated drivers admitted during an 18-month period. Court records identified patients who had been charged with traffic offenses, including prior (2 years) and subsequent (1 year) charges. Blood alcohol concentration (BAC) was measured in 387 (74%) of 525 drivers, of whom 137 (35%) had BAC >=100 mg/dL. Of 113 state residents, 22 (19%) were charged with an offense related to the MVC. Of 12 charged with DUI, 10 were convicted, for an overall DUI conviction rate of just 9%. Seven (32%) of those who were charged had prior or subsequent charges. Of 91 patients not charged for the index event, 31 (34%) had prior or subsequent charges. Alcohol is involved in a large percentage of MVCs in our region. The infrequency of prosecution for DUI despite property damage and/or personal injury, and the high recidivism rate, are significant social concerns. These data suggest the need for processes to facilitate legal prosecution—possibly including revision of legislation involving reporting of BACs.Traffic collisions are an important public health problem worldwide, in terms of mortality, morbidity, and economic burden. The goal of this study is to estimate the social cost of injured people in traffic collisions in Catalonia in the year 2007. The authors performed a cost-of-illness analysis, under the perspective of the healthcare system, the public sector, and the society, using a 1-year time horizon. In Catalonia, during 2007, there were a total of 26,063 collisions with victims, which translates into 34,565 non-mortal victims and 521 deaths. As direct costs, all healthcare costs (primary care, acute hospital care, emergency care, ambulances and transport, long-term care, and specialized care); costs of adaptation to disability, disability benefits, material costs, and administrative costs; and costs of police, fire-fighters, and road assistance have been included. As indirect costs, productivity losses as a result of hospital and long-term institutionalization as well as productivity losses from work sick leave and productivity losses of carers have been taken into account. From the perspective of the healthcare system, the cost of the injured people in traffic collisions was 31,803,024.03€ in 2007; from the perspective of the public sector, it was 134,047,059.27€ (up to 1,463,645,407.13€ in the sensitivity analysis) and 144,043,238.88€ (up to 1,558,926,995.12€ in the sensitivity analysis) from the perspective of the society. The cost per injured person ranged from 3,855.38€ from the perspective of the healthcare system to 17,461.90€ from the perspective of the society (up to 188,983.76€ in the sensitivity analysis). It was concluded that the importance of the costs of injured people in traffic collisions is an argument more-besides the epidemiologic and social impact-to start off preventive policies. (Author/publisher)
Samenvatting