During the last decades the number of registered in-patients has decreased much less rapidly than the number of road deaths. Based on an analysis of data on in-patients, SWOV concludes that these patients are not always as severely injured as one might think. Now the question arises as to whether hospital admission is a useful road safety indicator for road safety. At her 45th anniversary conference SWOV argued for using a different indicator for casualties other than road deaths.
1984-2005 injury data analyzed
During the 1984-2005 period the number of registered road deaths decreased by 54%, whereas the number of road crash in-patients recorded in the hospitals' National Patient Register decreased by only 16%, from 20,800 to 17,400. This decrease was a lot less spectacular. However, it is striking that the number of road deaths who died in a hospital decreased as steeply as the total number of registered road deaths.
In order to explain this difference between the road deaths and the severely injured, SWOV analyzed data on injury and other characteristics of road crash in-patients for the 1984-2005 period.
Hospital admission not synonymous to severely injured
From the analyzed data, SWOV concluded that a proportion of those patients labelled as 'severely injured' did not warrant this classification, and that 'hospital admissions/in-patients' and 'severely injured' were often mistakenly confused. An increasing proportion, now 8%, is only admitted for one night for observation purposes, without actually having any injury. Another 14% only had slight injury. Truly severely injured are those whose injury consists of heavy fractures, dislocation, sprains, heavy concussion, or internal injuries. In general, it takes weeks to recover from such injuries, followed by rehabilitation, and can often result in permanent injury.
Fewer injuries after road crashes
The average number of injuries per patient among the road crash casualties decreased by 17%.This decrease occurred mainly among the patients with more than three injuries. Not only did the number of injuries per person decrease, also the injury severity lessened. After deducting those only admitted for observation, the 8%, the remaining number of in-patients decreased by a fifth over the last 20 years. This indicates that the road safety improvement has had its effect on the number of in-patients.
Increasing numbers of injured among cyclists
After correction, the decrease of in-patients is mainly among car occupants. Their injury severity also decreases in this group of road users. On the other hand, the injury severity of cyclists, by far the largest group of road crash in-patients, hardly decreases at all. SWOV recommends studying the injured cyclists in greater detail because for this group there is also an increase in the total number of road crash injured. The fact that the number of road deaths has decreased faster than the number of 'really severely injured' and the reduction in injury severity leads to theconclusion that crashes have less serious consequences than in the past.
Severe injury is a better road safety indicator
SWOV would like to give into consideration that not the number of in-patients, but the number of severely injured be used as road safety indicator in future road safety and road safety policy monitoring. This data seems to provide a more accurate road safety picture. Such a change requires consultation with various parties because it has consequences for the formulated road safety targets.
The publication entitled Hospitalized road crash injured; Developments in numbers, injury severity, and length of stay since 1984, R-2007-2 has been available at www.swov.nl from 26th April 2007. The report is in Dutch, but has an English summary.
|
