Comparing motorcycle-related hospitalizations in U.S. states

Most people know that using a motorcycle helmet reduces the overall motorcycle fatality rate, but what happens to the non-fatal injury rates, and do state helmet laws make a difference in the number and severity of these injuries? Jeffrey Corben and his colleagues at the West Virginia Injury Control Research Center looked at the hospitalization data.

In the USA, motorcycles are increasing in popularity, and since 1997, the number of motorcycle-related fatalities have been increasing as well, but this increase has exceeded the increasing rate of motorcycle registrations. Several factors are associated with the increase in fatalities: 1) the mean age of motorcyclists killed as increased and the number of rider deaths among those over age 40 has increased by 200%, 2) engine size of motorcycles in fatal crashes has been steadily increasing since 1993, 3) more fatalities now occur on rural than on urban roads. One thing hasn’t changed – the overall proportion of alcohol involved in fatal motorcycle crashes has actually declined, but the percentage of motorcycle operator involvement in fatal crashes continues to be higher than any other type of motor vehicle driver.

Corben and his colleagues obtained data from the Healthcare Coast and Utilization Project and looked specifically at motorcycle injury hospitalizations. They classified the data according to type of injury, along with other information on hospital stay and discharge. Then they further examined the data by three types of helmet laws in effect in the states: a universal compulsory helmet law, a partial law requiring only certain riders to use helmets, and no helmet law. Only three states had no  laws, so data was analyzed in two groups: states with universal laws and states with partial/no laws.

Here’s what they found: In states without universal laws hospitalized cases were more likely to have intracranial injury. These cases had higher treatment costs, and they were more likely to be transferred to long-term care facilities following their initial hospitalization. Nearly 25% of cases with an intracranial injuries from states with no universal laws were admitted to a long-term care facility. Even for other diagnoses, like fractured extremities, more cases wound up in long-term facilities. Cases from states without universal helmet laws were also more likely to lack private medical insurance.

Although there are limitations to this study, such as lack of specific helmet use information, actual cost information, and more information on long-term care stays, the authors conclude that their finding have particular concerns for policy makers who are contemplating the removal of universal helmet laws. First, without a law, helmet usage will be sharply reduced. Second, fatalities will increase. Third, according to this study, the resulting numbers of non-fatal hospitalizations are likely to be severe, costly, and result in increased numbers of long-term facility admissions. Since proportionately more of the injuries are likely to be uninsured, these costs will fall upon society.

References: Corben JH, Steiner CA, Miller TR. Characteristics of motorcycle-related hospitalizations: Comparing states with different helmet laws. Acc Anal Prev 2007;39:190-196.

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