Correlation of ride sharing service availability and decreased alcohol-related motor vehicle collision incidence and fatality

Abstract

BACKGROUND Alcohol-related motor vehicle collisions (AR-MVCs) account for ~30% of all US traffic fatalities. Ride-sharing services (RSS) have existed since 2010, but few studies to date have investigated their impact on AR-MVCs. We hypothesized that the availability of RSS would be correlated with a decrease in AR-MVCs at an urban Level I trauma center. METHODS A retrospective chart review was conducted of all AR-MVC trauma activations at a Level I trauma center from 2012 to 2018. Additional data were gathered from regional governmental traffic and law enforcement databases, including crash incidence, fatalities, and demographics. Data were compared pre- and post-RSS and analyzed using an unpaired t test with p less than 0.05 considered significant. RESULTS There were 1,474 patients in AR-MVCs during the study period. There was a significant decrease in the annual average proportion of MVCs that were AR-MVCs pre- vs. post-RSS (39% vs. 29%, p = 0.02) as well as a decrease in the average annual incidence of fatal AR-MVCs (11.6 vs. 5, p = 0.02). Subset analysis showed a decrease in AR-MVC incidence in 18- to 29-year-olds (12.7% vs. 7.5%; p = 0.03), which was also demonstrated by data from a local law enforcement database. Availability of RSS was also correlated with a decreased proportion of nighttime AR-MVCs (14.7% vs. 7.6%, p = 0.03) and decreased number of driving while intoxicated (1198.0 ± 78.5 vs. 612.8 ± 137.6, p = <0.01). CONCLUSION We found that the incidence of both total AR-MVCs and fatal AR-MVCs presenting to our trauma center decreased after the introduction of RSS. Ride-sharing services may play a role in preventing AR-MVCs. Further research is needed to correlate AR-MVC incidence with granular proprietary RSS usage data and to account for any confounding factors. Future studies may identify ways to better utilize RSS availability as a targeted intervention for certain demographic groups to prevent AR-MVCs. LEVEL OF EVIDENCE Therapeutic/Care Management, Level IV.

Decision strategies while intoxicated relate to alcohol-impaired driving attitudes and intentions.

“…Lacking a control condition did not allow us to test whether intoxicated decision strategies align with sober decision strategies which could inform interventions before a drinking episode. Early adulthood has the highest rates of AID, but middle-to-older adults may have differing views on ride services and distinct patterns of acute alcohol tolerance which could better inform interventions among an older age group (Friedman et al, 2020;Conner et al, 2021). Although we were able to classify most individuals into either compensatory or non-compensatory strategy use, future research should determine whether there are other decision making strategies being used or the absence of identifiable strategies among unclassified individuals.…”

“…Lacking a placebo condition did not allow us to test whether intoxicated decision strategies align with sober decision strategies which could inform interventions before a drinking episode. Early adulthood has the highest rates of AID, but middle-to-older adults may have differing views on ride services and distinct patterns of acute alcohol tolerance which could better inform interventions among an older age group (Conner et al, 2021; Friedman et al, 2020). We also did not collect or assess whether individuals had a history of DWI or being stopped in suspicion of impaired driving.…”

“…Perceived acceptability of AID alternatives by the general public predicts AID behavior (Fairlie et al, 2010; Turrisi & Jaccard, 1992), and facilitating the use of alternatives has long been a part of AID prevention efforts (see Fell et al, 2020 for a review). Ride service companies (e.g., Uber, Lyft) often claim that they reduce AID through decreasing the associated costs and increasing the convenience of securing a ride after drinking (Uber & Mothers Against Drunk Driving, 2015), and recent data provide some support for this argument (Conner et al, 2021; Friedman et al, 2020). Though ride service companies often offer a lower cost AID alternative, the monetary cost of ride services may still present a barrier that influences its use (McCarthy et al, 2021).…”

Longitudinal Trends in Severe Traumatic Brain Injury Inpatient Rehabilitation

“…Frontal airbags, which have been shown in trials to reduce the incidence of brain injury in frontal crashes, became a requirement for all passenger vehicles in the United States in 1999 21. Ridesharing applications such as Uber and Lyft became prevalent in most major cities in the United States between 2011 and 2014, and studies have suggested that they may reduce alcohol-related motor vehicle accidents 22,23. This premise is supported by data from the National Highway Traffic Safety Administration's roadside survey, which shows a decreasing trend in alcohol use among drivers from 1996 to 2014 24.…”

Logical Structure of Actions to Reduce the Impacts of Traffic Incidents

“…(2020) showed that the increase in population density, number of registered vehicles, number of holidays, average temperature, percentage of heavy vehicles and percentage of professionals' earners in a region increase in the number of occurrences of this type of incident. The study by Friedman et al (2020) showed that the incidence of alcohol-related motor vehicle accidents attended at the study trauma center decreased after the introduction of ride-sharing services, showing that this can be one of the solutions for preventing this type of accident.…”