Hospitalizations from covid-19: a health planning tool.

OBJECTIVE: Estimate the future number of hospitalizations from Covid-19 based on the number of diagnosed positive cases. METHOD: Using the covid-19 Panel data recorded in Spain at the Red Nacional de Vigilancia Epidemiológica, Renave (Epidemiological Surveillance Network), a regression model with multiplicative structure is adjusted to explain and predict the number of hospitalizations from the lagged series of positive cases diagnosed from May 11, 2020 to September 20, 2021. The effect of the time elapsed since the vaccination program starting on the number of hospitalizations is reviewed. RESULTS: Nine days is the number of lags in the positive cases series with greatest explanatory power on the number of hospitalizations. The variability of the number of hospitalizations explained by the model is high (adjusted R2: 96.6%). Before the vaccination program starting, the expected number of hospitalizations on day t was 20.2% of the positive cases on day t-9 raised to 0.906. After the vaccination program started, this percentage was reduced by 0.3% a day. Using the same model, we find that in the first pandemic wave the number of positive cases was more than six times that reported on official records. CONCLUSIONS: Starting from the covid-19 cases detected up to a given date, the proposed model allows estimating the number of hospitalizations nine days in advance. Thus, it is a useful tool for forecasting the hospital pressure that health systems shall bear as a consequence of the disease.

Hospitalizations from covid-19: a health planning tool / Ingresos hospitalarios por covid-19: una herramienta de planificación sanitaria

ABSTRACT OBJECTIVE Estimate the future number of hospitalizations from Covid-19 based on the number of diagnosed positive cases. METHOD Using the covid-19 Panel data recorded in Spain at the Red Nacional de Vigilancia Epidemiológica, Renave (Epidemiological Surveillance Network), a regression model with multiplicative structure is adjusted to explain and predict the number of hospitalizations from the lagged series of positive cases diagnosed from May 11, 2020 to September 20, 2021. The effect of the time elapsed since the vaccination program starting on the number of hospitalizations is reviewed. RESULTS Nine days is the number of lags in the positive cases series with greatest explanatory power on the number of hospitalizations. The variability of the number of hospitalizations explained by the model is high (adjusted R2: 96.6%). Before the vaccination program starting, the expected number of hospitalizations on day t was 20.2% of the positive cases on day t-9 raised to 0.906. After the vaccination program started, this percentage was reduced by 0.3% a day. Using the same model, we find that in the first pandemic wave the number of positive cases was more than six times that reported on official records. CONCLUSIONS Starting from the covid-19 cases detected up to a given date, the proposed model allows estimating the number of hospitalizations nine days in advance. Thus, it is a useful tool for forecasting the hospital pressure that health systems shall bear as a consequence of the disease.

RESUMEN OBJETIVO Predecir el número futuro de hospitalizaciones por covid-19 a partir del número de casos positivos diagnosticados. MÉTODO Usando datos del Panel covid-19 registrados en España en la Red Nacional de Vigilancia Epidemiológica (Renave), se ajusta un modelo de regresión con estructura multiplicativa para explicar y predecir el número de hospitalizaciones a partir de la serie retardada de casos positivos diagnosticados durante el periodo entre el 11 de mayo de 2020 y el 20 de septiembre de 2021. Se analiza el efecto sobre el número de hospitalizaciones del tiempo transcurrido desde el inicio del programa de vacunación. RESULTADOS El número de retardos de la serie de casos positivos que mayor capacidad explicativa tiene sobre el número de hospitalizaciones es de nueve días. La variabilidad del número de hospitalizaciones explicada por el modelo es elevada (R2 ajustado: 96,6%). Antes del inicio del programa de vacunación, el número esperado de ingresos hospitalarios en el día t era igual al 20,2% de los casos positivos del día t-9 elevado a 0,906. Iniciado el programa de vacunación, este porcentaje se redujo un 0,3% diario. Con el mismo modelo se obtiene que en la primera ola de la pandemia el número de casos positivos fue más de seis veces el que figura en los registros oficiales. CONCLUSIONES Partiendo de los casos de covid-19 detectados hasta una fecha, el modelo propuesto permite estimar el número de hospitalizaciones con nueve días de antelación. Ello lo convierte en una herramienta útil para prever con cierta anticipación la presión hospitalaria que el sistema sanitario tendrá que soportar como consecuencia de la enfermedad.

Differences in the risk profiles of drunk and drug drivers: Evidence from a mandatory roadside survey.

BACKGROUND: The study assesses the prevalence rates of alcohol- and drug-involved driving in Catalonia (Spain). METHOD: Drivers were randomly selected for roadside testing using a stratified random sampling procedure representative of all vehicles circulating on non-urban roads. Mandatory alcohol and drug tests were performed during autumn 2017. A sample of 6860 drivers were tested for alcohol use, of these 671 were also tested for drugs. Standard procedures were employed by traffic officers to detect alcohol and drug use. Alcohol breath tests were performed with breathalyser devices and on-site drug screening systems were used to test for drugs. RESULTS: The prevalence of alcohol use above the legal limit and drug use were 1.2 % (95 % CI: 0.9-1.5 %) and 8.3 % (95 % CI: 5.8-11.2 %), respectively. The most frequent drugs detected were THC (5.6 %, 95 % CI: 3.7-8.0 %), cocaine (3.5 %, 95 % CI: 2.0-5.5 %) and amphetamines (1.6 %, 95 % CI: 0.6-3.4 %). Alcohol use was detected more frequently on conventional roads, at weekends and during night-time hours. Drug use was detected more frequently in young males during daytime hours. CONCLUSIONS: Driver risk profiles associated with alcohol use and drug use differ. Positive alcohol use is not a predictor of drug use when controlling for all other factors.

Percentile charts for speeding based on telematics information.

Reference charts are widely used as a graphical tool for assessing and monitoring children's growth given gender and age. Here, we propose a similar approach to the assessment of driving risk. Based on telematics data, and using quantile regression models, our methodology estimates the percentiles of the distance driven at speeds above the legal limit depending on drivers' characteristics and the journeys made. We refer to the resulting graphs as percentile charts for speeding and illustrate their use for a sample of drivers with Pay-How-You-Drive insurance policies. We find that percentiles of distance driven at excessive speeds depend mainly on total distance driven, the percentage of driving in urban areas and the driver's gender. However, the impact on the estimated percentile for these covariates is not constant. We conclude that the heterogeneity in the risk of driving long distances above the speed limit can be easily represented using reference charts and that, conversely, individual drivers can be scored by calculating an estimated percentile for their specific case. The dynamics of this risk score can be assessed by recording drivers as they accumulate driving experience and cover more kilometres. Our methodology should be useful for accident prevention and, in the context of Manage-How-You-Drive insurance, reference charts can provide real-time alerts and enhance recommendations for ensuring safety.

"When I Retire, I'll Move Out of the City": Mental Well-being of the Elderly in Rural vs. Urban Settings.

This study examines the influence of risk factors on mental well-being at older ages focusing on the level of rurality of the living environment. We used cross-sectional, nationally representative survey data for Catalonia (Spain) from 2015 to 2017 to explain the mental well-being of the population aged 65 years and over. Based on a sample of 2621 individuals, we created a score of current mental well-being using the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS). Using logistic regression and non-parametric tests, we identified the sociodemographic, health and lifestyle variables which, in combination with the features of the rural and urban settings of the living space, were associated with poor SWEMWBS scores. Our results reveal that adequate social support is linked to expectations of good mental well-being in later life. Poor self-perceived health and ageing limitations are associated with less deterioration of the well-being for the elderly living in rural areas, whereas living in urban areas is linked to a higher risk of suffering from emotional distress attributable to economic difficulties or low educational attainment. Incentivizing older people to live in rural environments could result in greater well-being in the last stages of life; appropriate prospective studies are needed to test this positive outcome.

Prevalence of drug use among drivers based on mandatory, random tests in a roadside survey.

BACKGROUND: In the context of road safety, this study aims to examine the prevalence of drug use in a random sample of drivers. METHODS: A stratified probabilistic sample was designed to represent vehicles circulating on non-urban roads. Random drug tests were performed during autumn 2014 on 521 drivers in Catalonia (Spain). Participation was mandatory. The prevalence of drug driving for cannabis, methamphetamines, amphetamines, cocaine, opiates and benzodiazepines was assessed. RESULTS: The overall prevalence of drug use is 16.4% (95% CI: 13.9; 18.9) and affects primarily younger male drivers. Drug use is similarly prevalent during weekdays and on weekends, but increases with the number of occupants. The likelihood of being positive for methamphetamines is significantly higher for drivers of vans and lorries. CONCLUSIONS: Different patterns of use are detected depending on the drug considered. Preventive drug tests should not only be conducted on weekends and at night-time, and need to be reinforced for drivers of commercial vehicles. Active educational campaigns should focus on the youngest age-group of male drivers.

Feeling good in old age: factors explaining health-related quality of life.

BACKGROUND: Sustained growth in longevity raises questions as to why some individuals report a good quality of life in older ages, while others seem to suffer more markedly the effects of natural deterioration. Health-related quality of life (HRQL) is mediated by several easily measurable factors, including socio-demographics, morbidity, functional status and lifestyles. This study seeks to further our knowledge of these factors in order to outline a profile of the population at greater risk of poor ageing, and to identify those attributes that might be modified during younger stages of the life course. METHODS: We use nationally representative data for Catalonia (Spain) to explain the HRQL of the population aged 80-plus. Cross-sectional data from 2011 to 2016 were provided by an official face-to-face survey. HRQL was measured using EQ-VAS - the EuroQol-5D visual analogue scale - which summarizes current self-perceived health. Multivariate linear regression was used to identify variables influencing the EQ-VAS score. RESULTS: Sociodemographic factors, including being older, female, poorly educated and belonging to a low social class, were related with poor HRQL at advanced ages. The presence of severe mobility problems, pain/discomfort, and anxiety/depression were highly correlated to the HRQL of the elderly, while problems of self-care and with usual activities had a weaker association. CONCLUSIONS: Encouraging the young to stay in education, as well as to adopt healthier lifestyles across the lifespan, might ensure better HRQL when individuals reach old age. More multidisciplinary research is required to understand the multifaceted nature of quality of life in the oldest-old population.

Circular con tasa de alcohol superior a la legal: caracterización del conductor según la vía de circulación / Driving with alcohol content above the legal limits: profile of the driver according to the type of road

Se realiza un estudio transversal de los controles policiales para la medición de la tasa de alcohol en aire espirado (AAE) llevados a cabo en Cataluña en el año 2013. La muestra consta de 464.134 pruebas, de las cuales el 66% se realizaron en vías interurbanas y el 34% en vías urbanas. Método: Se mide si el conductor sobrepasa el límite legal en miligramos de alcohol por litro de aire espirado. En el caso de conductores noveles o profesionales el límite legal es de 0,15 mg/l y para el resto de conductores es de 0,25 mg/l. Se realiza un análisis descriptivo del porcentaje de conductores detectados por encima del límite legalmente permitido en vías interurbanas y en vías urbanas, según características del conductor y del vehículo, motivo de la prueba, y momento en que se lleva a cabo. En una segunda parte, se ajustan dos modelos lineales generalizados con vínculo logarítmico y familia binomial, según si la prueba se realiza en vía interurbana o en vía urbana. Resultados: La edad del conductor, la nacionalidad o la franja horaria en la que se realiza la prueba inciden de forma diferente en la probabilidad de sobrepasar el límite legal de alcohol, dependiendo de si la prueba se realiza en vía interurbana o urbana. Conclusión: Diseñar políticas de seguridad vial específicas según el tipo de vía puede ayudar a reducir la proporción de conductores que superan los límites legales de alcohol en aire espirado y, por tanto, la accidentalidad

A cross-sectional study of the alcohol breath tests carried out by police officers in Catalonia in 2013 is performed. The sample consists of 464,134 breath tests, of which 66% were held on interurban roads and 34% on urban roads. Method: We measure whether the driver exceeds the legal limit in milligrams of alcohol per litre of exhaled air. For novice or professional drivers the legal limit is 0.15 mg/l, while for other drivers it is 0.25 mg/l. First, a descriptive analysis of the percentage of drivers detected above the legally permitted limit on interurban and urban roads is performed. It takes into account the characteristics of the driver and the vehicle, the reason for the test, and the timeframe. Afterwards, two generalized linear models with binomial family and logarithmic link are adjusted, depending on whether the test is conducted on interurban or urban roads. Results: Driver age, nationality or timeframe affect the probability of exceeding the alcohol legal limit differently, depending on whether the test is conducted on interurban or urban roads. Conclusion: Designing road safety policies adapted to the type of road can help reduce alcohol-impaired driving and therefore accident rates

Educational attainment, gender and health inequalities among older adults in Catalonia (Spain).

BACKGROUND: Health expectancies vary worldwide according to socioeconomic status (SES), with health disadvantages being evident among lower SES groups. Using educational attainment as a proxy of SES, we seek to identify trends in SES differentials in health by gender, with a particular focus on individuals with low educational attainment in the adult Catalan population (Spain) aged 55 or older. METHODS: Using cross-sectional data for 1994 and 2010-2014 drawn from the Catalan Health Survey, we examined three health indicators to document social health inequalities: self-perceived health, functional limitations, and restrictions on activities of daily living (ADL). We applied logistic models for each indicator, controlling for sociodemographic characteristics, health coverage and health behaviours. RESULTS: Among the less-educated, females presented a greater improvement in their self-perceived health over time than did their male counterparts, there being no significant variations among the medium/high educated. Regardless of education, males showed an increase in the prevalence of functional problems (as did the women, but the increase was not statistically significant). Both genders presented a higher prevalence of limitations when performing ADL in the second time period. The gender health gap was reduced slightly both for the low and the medium/high educated, expect in the case of ADL restrictions. Health and functioning differences by education level persisted, but showed significant signs of reduction. CONCLUSIONS: Less-educated females constitute the most disadvantaged group in terms of health and personal autonomy, though there are encouraging signs that the gap is closing both in terms of gender and level of education. Health policymakers need to devote particular attention to the aging population with low SES, especially to women. Public programmes promoting greater protection and equity, while fostering preventive and healthy practices, need to target the most underprivileged.

Risk of dependence associated with health, social support, and lifestyle.

OBJECTIVE To analyze the prevalence of individuals at risk of dependence and its associated factors. METHODS The study was based on data from the Catalan Health Survey, Spain conducted in 2010 and 2011. Logistic regression models from a random sample of 3,842 individuals aged ≥ 15 years were used to classify individuals according to the state of their personal autonomy. Predictive models were proposed to identify indicators that helped distinguish dependent individuals from those at risk of dependence. Variables on health status, social support, and lifestyles were considered. RESULTS We found that 18.6% of the population presented a risk of dependence, especially after age 65. Compared with this group, individuals who reported dependence (11.0%) had difficulties performing activities of daily living and had to receive support to perform them. Habits such as smoking, excessive alcohol consumption, and being sedentary were associated with a higher probability of dependence, particularly for women. CONCLUSIONS Difficulties in carrying out activities of daily living precede the onset of dependence. Preserving personal autonomy and function without receiving support appear to be a preventive factor. Adopting an active and healthy lifestyle helps reduce the risk of dependence.

Are we living longer but less healthy? Trends in mortality and morbidity in Catalonia (Spain), 1994-2011.

Evidence on trends in prevalence of disease and disability can clarify whether countries are experiencing a compression or expansion of morbidity. An expansion of morbidity, as indicated by disease, has appeared in Europe and other developed regions. It is likely that better treatment, preventive measures, and increases in education levels have contributed to the declines in mortality and increments in life expectancy. This paper examines whether there has been an expansion of morbidity in Catalonia (Spain). It uses trends in mortality and morbidity and links these with survival to provide estimates of life expectancy with and without diseases and mobility limitations. We use a repeated cross-sectional health survey carried out in 1994 and 2011 for measures of morbidity, and information from the Spanish National Statistics Institute for mortality. Our findings show that at age 65 the percentage of life with disease increased from 52 to 70 % for men, and from 56 to 72 % for women; the expectation of life with mobility limitations increased from 24 to 30 % for men and from 40 to 47 % for women between 1994 and 2011. These changes were attributable to increases in the prevalence of diseases and moderate mobility limitation. Overall, we find an expansion of morbidity along the period. Increasing survival among people with diseases can lead to a higher prevalence of diseases in the older population. Higher prevalence of health problems can lead to greater pressure on the health care system and a growing burden of disease for individuals.

Risk of dependence associated with health, social support, and lifestyle / Riesgo de dependencia asociado a la salud, el apoyo social y el estilo de vida

OBJECTIVE To analyze the prevalence of individuals at risk of dependence and its associated factors.METHODS The study was based on data from the Catalan Health Survey, Spain conducted in 2010 and 2011. Logistic regression models from a random sample of 3,842 individuals aged ≥ 15 years were used to classify individuals according to the state of their personal autonomy. Predictive models were proposed to identify indicators that helped distinguish dependent individuals from those at risk of dependence. Variables on health status, social support, and lifestyles were considered.RESULTS We found that 18.6% of the population presented a risk of dependence, especially after age 65. Compared with this group, individuals who reported dependence (11.0%) had difficulties performing activities of daily living and had to receive support to perform them. Habits such as smoking, excessive alcohol consumption, and being sedentary were associated with a higher probability of dependence, particularly for women.CONCLUSIONS Difficulties in carrying out activities of daily living precede the onset of dependence. Preserving personal autonomy and function without receiving support appear to be a preventive factor. Adopting an active and healthy lifestyle helps reduce the risk of dependence.

OBJETIVO Analizar la prevalencia de personas en riesgo de dependencia y los factores asociados.MÉTODOS El estudio se basó en datos de la Encuesta de Salud de Cataluña, España, realizada de 2010 a 2011. A partir de una muestra aleatoria de 3.842 individuos, de 15 años o más, se llevaron a cabo modelos de regresión logística para clasificar a los individuos según el estado de su autonomía personal. Se plantearon modelos predictivos para identificar las variables susceptibles de intervención que permitieran distinguir a los individuos dependientes de aquellos en riesgo. Se consideraron variables acerca del estado de salud, apoyo social y estilos de vida.RESULTADOS El 18,6% de la población presentó riesgo de dependencia, con efecto más acusado a partir de los 65 años. En comparación con este colectivo, los individuos que se declararon dependientes (11,0%) manifestaron problemas para realizar las actividades cotidianas y obtuvieron apoyo para ello. Estilos de vida, como fumar, consumir alcohol en exceso y ser sedentario se asociaron con mayor probabilidad de dependencia, en particular para las mujeres.CONCLUSIONES Las dificultades para llevar a cabo las actividades cotidianas preceden a la aparición de dependencia. Preservar la propia autonomía y desenvolverse sin recibir apoyo aparecen como factores protectores. La adopción de un estilo de vida activo y saludable contribuye a reducir el riesgo de dependencia.

Prevalencia y condicionantes de la obesidad en la población infantojuvenil de Cataluña, 2006-2012 / Prevalence and determinants of obesity in children and young people in Catalonia, Spain, 2006-2012

Fundamento y objetivo: Estimar la prevalencia de obesidad y sobrepeso en la población catalana de 2 a 14 años, conocer su evolución durante los períodos 2006 y 2010-2012 y evaluar los determinantes sociales y estilos de vida relacionados con la obesidad. Material y métodos: Estudio transversal a partir de 4.389 encuestas correspondientes a las ediciones 2006 y 2010-2012 de la Encuesta de Salud de Cataluña. El sobrepeso y la obesidad se determinaron aplicando los criterios de la Organización Mundial de la Salud. Los condicionantes evaluados fueron la clase social, el nivel de estudios de los padres/madres, los hábitos alimentarios, las actividades de ocio y el sueño. Resultados: Durante el período 2010-2012, las prevalencias de obesidad y sobrepeso fueron, respectivamente, 15,4 y 20,2%. La obesidad fue superior en niños (15,5%) que en niñas (12,8%) (p < 0,05), y superior en el grupo de 2 a 9 años (17,5%) que en el de 10 a 14 años (7,7%) (p < 0,05). Durante el período 2006, las prevalencias de obesidad y sobrepeso fueron similares a las observadas durante 2010-2012. La clase social baja y el bajo nivel de estudios de los progenitores se relacionaron significativamente con una mayor prevalencia de obesidad. Conclusiones: La obesidad y el sobrepeso en la población infantojuvenil catalana se han mantenido estables durante 2006-2012, siendo de las más altas de Europa. Para afrontar este importante problema de salud pública, es necesario un enfoque integral e interdisciplinario que considere tanto los determinantes sociales como los estilos de vida del entorno infantil (AU)

Background and objective: To estimate the prevalence of obesity and overweight in children aged 2 to 14 years in Catalonia, its trends between 2006 and 2010-2012, and to evaluate social determinants and lifestyle associated with obesity. Material and methods: A cross-sectional study, using the data from 4,389 surveys from Catalonia Health Surveys of the years 2006 and 2010-2012, was conducted. Obesity and overweight were determined by World Health Organization criteria. Socioeconomic position, parent's education, usual diet and activity, and hours of sleep were assessed. Results: The prevalence of obesity and overweight were: 15.4 and 20.2% in 2010-2012. The prevalence of obesity was higher in boys (15.5%) compared to girls (12.8%) (P < .05), and higher in children ranging from 2 to 9 years old (17.5%) than children aged 10 to 14 years (7.7%) (P < .05). In 2006, the prevalence of obesity and overweight were similar to the prevalence in 2010-2012. Obesity was more frequent in children with parents with a low socioeconomic position and/or a primary or elementary parent's education. Conclusions: During the last 5 years (2006-2012), child obesity and overweight have remained stable in Catalonia, yet they are relatively high in Europe. Public health programmes against obesity must consider conducting an intersectional action taking social determinants and family life styles into account (AU)

[Prevalence and determinants of obesity in children and young people in Catalonia, Spain, 2006-2012]. / Prevalencia y condicionantes de la obesidad en la población infantojuvenil de Cataluña, 2006-2012.

BACKGROUND AND OBJECTIVE: To estimate the prevalence of obesity and overweight in children aged 2 to 14 years in Catalonia, its trends between 2006 and 2010-2012, and to evaluate social determinants and lifestyle associated with obesity. MATERIAL AND METHODS: A cross-sectional study, using the data from 4,389 surveys from Catalonia Health Surveys of the years 2006 and 2010-2012, was conducted. Obesity and overweight were determined by World Health Organization criteria. Socioeconomic position, parent's education, usual diet and activity, and hours of sleep were assessed. RESULTS: The prevalence of obesity and overweight were: 15.4 and 20.2% in 2010-2012. The prevalence of obesity was higher in boys (15.5%) compared to girls (12.8%) (P<.05), and higher in children ranging from 2 to 9 years old (17.5%) than children aged 10 to 14 years (7.7%) (P<.05). In 2006, the prevalence of obesity and overweight were similar to the prevalence in 2010-2012. Obesity was more frequent in children with parents with a low socioeconomic position and/or a primary or elementary parent's education. CONCLUSIONS: During the last 5 years (2006-2012), child obesity and overweight have remained stable in Catalonia, yet they are relatively high in Europe. Public health programmes against obesity must consider conducting an intersectional action taking social determinants and family life styles into account.

Prevalence of alcohol-impaired drivers based on random breath tests in a roadside survey in Catalonia (Spain).

Sobriety checkpoints are not usually randomly located by traffic authorities. As such, information provided by non-random alcohol tests cannot be used to infer the characteristics of the general driving population. In this paper a case study is presented in which the prevalence of alcohol-impaired driving is estimated for the general population of drivers. A stratified probabilistic sample was designed to represent vehicles circulating in non-urban areas of Catalonia (Spain), a region characterized by its complex transportation network and dense traffic around the metropolis of Barcelona. Random breath alcohol concentration tests were performed during spring 2012 on 7596 drivers. The estimated prevalence of alcohol-impaired drivers was 1.29%, which is roughly a third of the rate obtained in non-random tests. Higher rates were found on weekends (1.90% on Saturdays and 4.29% on Sundays) and especially at night. The rate is higher for men (1.45%) than for women (0.64%) and it shows an increasing pattern with age. In vehicles with two occupants, the proportion of alcohol-impaired drivers is estimated at 2.62%, but when the driver was alone the rate drops to 0.84%, which might reflect the socialization of drinking habits. The results are compared with outcomes in previous surveys, showing a decreasing trend in the prevalence of alcohol-impaired drivers over time.

Factors affecting hospital admission and recovery stay duration of in-patient motor victims in Spain.

Hospital expenses are a major cost driver of healthcare systems in Europe, with motor injuries being the leading mechanism of hospitalizations. This paper investigates the injury characteristics which explain the hospitalization of victims of traffic accidents that took place in Spain. Using a motor insurance database with 16,081 observations a generalized Tobit regression model is applied to analyse the factors that influence both the likelihood of being admitted to hospital after a motor collision and the length of hospital stay in the event of admission. The consistency of Tobit estimates relies on the normality of perturbation terms. Here a semi-parametric regression model was fitted to test the consistency of estimates, concluding that a normal distribution of errors cannot be rejected. Among other results, it was found that older men with fractures and injuries located in the head and lower torso are more likely to be hospitalized after the collision, and that they also have a longer expected length of hospital recovery stay.

The impact of traffic violations on the estimated cost of traffic accidents with victims.

We analyse accidents with victims and calculate the influence of traffic violations on the probability of having a serious or fatal accident, compared to a slight accident. Traffic violations related to speed limitations, administrative infringements or faults related to the driver are considered. Data were obtained from all available reports on accidents with victims that occurred in Spain from 2003 to 2005. A multinomial logistic regression model is specified to find the probability that an accident with victims is slight, serious or fatal, given the presence/absence of thirty different types of traffic violations. The average cost per victim and the average number of victims per accident are then used to find the estimated cost of an accident with victims, given the information on the traffic violations incurred. This demonstrates which combinations of traffic violations lead to higher estimated average costs, compared to cases in which no traffic violation occurred. We conclude with some recommendations on the severity of penalties, and suggest that regulators penalize the occurrences of some specific combinations of traffic violations more rigorously.