Attributable hospital costs, home care costs and risk of long-term sickness benefits following traffic injuries by road user type

Background: Traffic injuries involving vulnerable road users tend to be forgotten in the political prioritisation in many countries. The underreporting of traffic crashes in vulnerable road users is much higher than that of crashes involving cars. Sometimes, it is even argued that underreported crashes in vulnerable road users are costless. In this study, we aimed to estimate the hospital and home care costs, as well as the risk of long-term sickness benefits, associated with a traffic injury by road user type in the first year after the injury.
Methods: The study used a complete sample of traffic injuries treated in emergency rooms and hospitals in Denmark. We applied a nationwide case-crossover design to the data, comprising 47,242 hospital-registered traffic injuries, of which 14,246 were cyclist injuries and 17,193 were pedestrian injuries, including pedestrian falls. We estimated the attributable hospital and home care costs following the traffic injuries in a two-part model and the excess risk of long-term sickness benefits beyond four weeks in a binomial regression model, taking into account that the data originated from a case-crossover design.
Results: We found that cyclist injuries were as costly as car injuries. Comparing all road users, we found that the most expensive traffic injuries were those of motorcyclists, moped drivers and pedestrians involved in multiparty crashes.
Conclusion: Traffic injuries involving vulnerable road users reach a price level similar to that of car injuries. The underreporting of crashes in vulnerable road users can, however, imply that road authorities choose safety measures that prevent car–car crashes instead of those that prevent crashes involving vulnerable road users, such as single-bicycle crashes or pedestrian falls. The outcome of this lack of knowledge and recognition is a biased prioritisation of the limited resources for road safety work.