Economic valuation of preventing fatal and serious road injuries. Results of a Willingness-To-Pay study in four European countries.

This paper presents the results of a stated choice study for estimating the Willingness-To-Pay of respondents in four European countries (Belgium, France, Germany and the Netherlands) to reduce the risk of fatal and serious injuries in road crashes. Respondents were confronted with hypothetical route choices that differ in respect of travel costs, travel time and crash risk. The survey was completed by 8,002 respondents, equally spread over the four participating countries and representative for each country with regards to gender, age and region. Possible biases caused by problematic choice behaviour such as inconsistent, irrational or lexicographic answers were addressed. The resulting values were estimated by means of a mixed logit model allowing to account for the panel nature of the data. The Value of a Statistical Life (VSL) was estimated at 6.2 Mill EUR, the Value of a Statistical Serious Injury (VSSI) at 950,000 EUR, and the Value of Time (VoT) at 16.1 EUR/h. Consequently, the relative value of avoiding a fatal injury is estimated to be around 7 times higher than the value of an avoided serious injury. The study revealed differences between countries with France showing values that are significantly lower than the average and Germany showing values that are significantly higher. The estimated VSL values are considerably higher than the values currently used in the four countries, but they are within the range of values found in similar stated choice studies. The results can be used as an input in a broad range of socioeconomic studies including cost-benefit analysis and assessments of socioeconomic costs of road crashes.

Estimated number of seriously injured road users admitted to hospital in France between 2010 and 2017, based on medico-administrative data.

BACKGROUND: In France, like in most developed countries, the number of road accident fatalities is estimated from police data. These estimates are considered to be good-quality, unlike estimates of road injuries admitted to hospital, and especially serious injuries. METHODS: The present study aimed to supply such data from French hospital medical information data-bases (PMSI). In the PMSI data-bases, road accident victims are identified by external causes of morbidity and mortality, which should be systematically recorded in case of injury, but are often missing. We therefore modeled presence/absence of external cause from the relevant subset of the medicine-surgery-obstetrics PMSI data-base using a logistic regression, and then weighting the results by inverse estimated probability. As ICD-10 coding does not include injury severity, we used the AAAM10 conversion instrument developed by the American Association for Automotive Medicine, originators of the Abbreviated Injury Scale, so as to conform to the European Commission's definition of serious injury. RESULTS: The number of road-accident related hospital admissions is estimated to be about 100000 per year; serious injuries increased from about 18000 in 2010 to almost 20000 in 2017, with almost 17000 in 2012 and 2013, with a mean of one fatality per 5 serious injury admissions. CONCLUSIONS: These serious injury estimates are close to those obtained by our team from other data and with a different estimation method. The present method has the advantage of using ICD codes for injured people admitted to hospital. This classification and data source (hospital discharge registry) are also used by most european countries reporting serious injury estimates to the Commission. It allows cost estimation of hospital care, and could be applied to other types of accidental injury.