Improving the timeliness and accuracy of injury severity data in road traffic accidents in an emerging economy setting.

Road traffic injuries (RTIs) are among the leading causes of injury and fatality worldwide. RTI casualties are continually increasing in Taiwan; however, because of a lack of an advanced method for classifying RTI severity data, as well as the fragmentation of data sources, road traffic safety and health agencies encounter difficulties in analyzing RTIs and their burden on the healthcare system and national resources. These difficulties lead to blind spots during policy-making for RTI prevention and control. After compiling classifications applied in various countries, we summarized data sources for RTI severity in Taiwan, through which we identified data fragmentation. Accordingly, we proposed a practical classification for RTI severity, as well as a feasible model for collecting and integrating these data nationwide. This model can provide timely relevant data recorded by medical professionals and is valuable to healthcare providers. The proposed model's pros and cons are also compared to those of other current models.

Differences in urban and rural accident characteristics and medical service utilization for traffic fatalities in less-motorized societies.

INTRODUCTION: Fatalities from traffic accidents in less-motorized societies are an important global issue. We aimed to characterize the geographic differences of fatalities in such societies to facilitate the development of targeted interventions. METHOD: This study linked police reports, hospital data, and vital registration data from Taiwan with special reference to accident factors in pre-hospital deaths and medical care in hospital deaths. RESULTS: A higher percentage of pre-hospital deaths were observed following rural as compared to urban traffic accidents. The deaths due to rural accidents can be attributed to lower use of restraints (i.e., helmets or seat belts), lower percentage of motorcyclists, and more highway accidents. A higher percentage of victims in rural accidents were transported to distant medical centers rather than to local hospitals. CONCLUSION: Specific interventions, such as intelligent emergency medical systems, campaigns for helmets and seat belt usage, enforcement of helmets and seat belt use, and speed control measures should be targeted to rural areas. IMPACT ON INDUSTRY: Cooperation between the vehicle industry and emergency medical providers in rural traffic accident rescue teams may decrease the numbers of deaths in these regions.

Mortality burden from motor vehicle accidents in Taiwan.

OBJECTIVE: To examine the risk factors contributing to the mortality burden due to road traffic accidents (RTA) in Taiwan. DESIGN: We compared RTA years of life lost (YLL) rates of Taiwan with those of the surrounding region. We also investigated the risk factors described by the police in a Linked Database combined from police-reported accident data and vital registration data. SAMPLE: RTA deaths (3,234 males/1,160 females) in vital registration data and the deaths (2,918 males/1,063 females) in the Linked Database were used. MEASUREMENT: YLL and YLL rate. RESULTS: (1) YLL rates for 15-29 year olds were the highest for Taiwan and the surrounding region. (2) The YLL rate was remarkably high in the first 2 years of the legal motorcycle licensing age for males riding motorcycles. (3) The YLL rates were usually higher during the day, but were higher for young males at night. (4) Overall, the YLL rates were higher when multiple vehicles were involved and for motorcycles with large engines; however, the rate was higher for motorcycles with small engines for the older female group. CONCLUSIONS: The burden due to premature mortality in RTA showed gender disparities and varied by age among personal, environment, and structure factors.

Using data linkage to generate 30-day crash-fatality adjustment factors for Taiwan.

Different countries have their own police reporting time standards for counting the number of fatalities in reported crashes. A rapid estimation method (such as adjustment factor) for the comparison is important. The data-linkage technique was used to combine police-reported crash data and vital registration data, in order to generate 30-day fatality adjustment factors for various reporting time standards, which could also shed light on the fatal injury trend over time. The major findings were as follows. Firstly, a conservative 30-day fatality adjustment factor for the first day (or 24 h) would be 1.54 (or 1.35) in an area with a large motorcycle population, like Taiwan. This produced 20-40% higher 30-day fatalities than UK Transport Research Laboratory predicted, and 15-25% higher fatalities than those in Europe/Japan. Secondly, after excluding motorcycle impacts, the Taiwanese factors suggested 8-14% higher fatalities within 30 days than those in Europe/Japan. Third, motorcycle fatalities influenced the overall 30-day fatality trend within 3 days. In the future, both the police under-reporting problem and the motorcycle/overall fatal injury pattern within 3 days after crashing in developing countries like Taiwan merit further investigation.