This in-depth crash investigation study was conducted to provide information about the causes and costs of a sample of serious (hospitalised) injury crashes in NSW. Between March 2010 and February 2013, participants were recruited following admission to participating NSW trauma hospitals due to injury as an occupant of a passenger motor vehicle. Participants were interviewed. The case vehicle and crash scene were inspected. Injury codes and cost data were obtained from hospital records. A multi-disciplinary Crash Review Team reviewed 94 crashes to agree on contributing factors, sources of injury, and recommended safety strategies, using a Safe Systems framework. Results highlight that common errors often resulted at least in part from features of the road environment. The Crash Review Team suggested strategies to address negative behaviours, including changes to the road environment and licensing system. Suggested injury mitigation strategies focused on improving vehicle restraint systems and structural integrity, as well as removing unprotected nonfrangible poles and trees that are close to the carriageway. Indices of driver fatigue collected from in-depth crash investigation were used to examine the set of operational criteria used in NSW to classify crashes as fatigue-related, via comparison with CrashLink data. Results suggest that fatigue-involvement in crashes would be improved by considering measures of specific fatigue risk factors (e.g. amount and quality of last sleep, duration of driving). In addition to providing average costs of in-hospital treatment (including by various levels of person-, vehicle-, and crash-characteristics), the project provided an opportunity for a small prospective case series study examining costs of injury for six months following discharge. Results suggest that the substantial financial costs are borne mostly by Medicare, Workcover, and CTP insurance, though participants reported experiencing financial strain due to up-front payments. Other stressors included being unable to work or to perform various everyday activities, and attending many medical appointments. Facilitating claims procedures may improve post-crash experience, and education campaigns that highlight “everyday” consequences of injury may assist with reducing risky driving behaviour. The present results should be interpreted in the context of methodological shortcomings. Implications for future in-depth crash investigation, and data linkage, are considered. (Author/publisher)
Samenvatting