Physical Impairment and Medical Care Spending by Road Accident Victims

Transcription

1 Young Researchers Seminar 2013 Young Researchers Seminar 2011 Lyon, France, June DTU, Denmark, June 8-10, 2011 Physical Impairment and Medical Care Spending by Road Accident Victims Hamza ACHIT DEST/IFSTTAR

2 Outline I. Introduction II. State of the Art III. Object of the study IV. Data, variables, methods V. Main results VI. Conclusion 2

3 I. Introduction Road traffic accidents are: - A major public health problem ninth main cause of GBD (Global Burden of Disease) [WHO] - Have an economic impact seriously injured every year costing 2% of EU GDP [European Commission, 2012] 3

4 I. Introduction Economic repercussions were often analyzed at the society level What about economic consequences for victims? Economic consequences for two main reasons: - Physical injuries can cause work disruption - High medical expenses due to health deterioration 4

5 II. State of the art Accident repercussions on victim s income and employment are by far the most studied - DANO (2004), DUGUET & LE CALINCHE (2012) Medical expenses and adherence to safety measures - BERGER & PILAND (1997) - LAWRANCE, MAX & MILLER (2003) 5

6 II. State of the art Effect of medical coverage on costs for victims and use of care HAAS (1994), DOYLE (2002) Different socioeconomic consequences for victims (income, employment, etc) CARNIS & al (2011) 6

7 III. Object of the study Original data about road victim s medical expenses Medical expenses incurred by victims with different disabilities How do victim s medical expenses vary? (age, seriousness of the injury, income, ) 7

8 IV. Data, variables, method Data: Disability & Health survey, France (2008) Sample: (N= 777), traffic -related disability Information: medical expenses Method: Explaining the total expenditure of out-ofhospital care, follow-up and rehabilitation 8

9 V. Main Results (1) Particular diseases related to road accidents (chronic) Source of recurring expenses ( LT consequences) ICD 10 classification N % Dorsopathies (Car accident back pain) % Arthropathies (Dashboard syndrome) % Injury, poisoning and certain other consequences of external causes % Episodic and paroxysmal disorders % 9

10 V. Main Results (2) Effect of seriousness of injury on different medical expenses (amount in euro) Average expense Total paralysis Partial paralysis, Amputation Title of the presentation Major joint discomfort Loss of muscular strength N Out-of-hospital care Transport Nursing care Pharmaceuticals Physiotherapy Out-of-hospital care + follow-up & rehabilitation

11 V. Main Results (3) The level of medical expenses is influenced: Primarily, by the seriousness of physical impairment Exemption from user fees The Age of the victims The Marital status The state of health of the victim 11

12 V. Main Results (4) No significant effect of: Gender Limited effect of socioeconomic variables Income Employment status Interaction effect between the variables age & seriousness of physical impairment 12

13 VI. Conclusion The microeconomic approach foregrounds important issues masked by an aggregated analysis Severely injured victims support high medical expenses Corporal damage leads to an acceleration of health capital deterioration Further investigations of LT consequences for road accident victims (medical expenses, health and well-being consequences, insurance coverage?) 13

14 Thank you for your attention IFSTTAR Cité Descartes Boulevard Newton Champs-sur-Marne Tél. +33 (0) Fax. +33 (0)

15 Variables Seriousness of physical impairment Reference category Total paralysis Domicile modification Yes No Age >70 years Category Coefficient Pr>T Partial paralysis <.0001*** Major discomfort <.0001*** Loss of muscular strength <.0001*** *** <25 years *** years <.0001*** years *** Sex Female Male Marital status Unmarried Married ** Widowed *** Divorced Employment status Working Unemployed Complementary Universal Health Care Coverage Income per unit of consumption State of health Yes <Minimum Welfare Benefit (RMI) (671.97) Very bad No * RMI-SMIG (minimum wage) * SMIG-2 SMIG SMIG-3 SMIG > 3 SMIG Good <.0001*** Average <.0001*** Poor <.0001*** Hospitalisation No Yes *** Exemption from user fee Not exempted Exempted *** Seriousness of physical impairment* age Title of the presentation *** 15