Motor Vehicle Crash and Hospital Charges in Front- and Rear-Seated Restrained and Unrestrained Adult Motor Vehicle Occupants

Abstract

There are reports that historically higher mortality observed for front- compared to rear-seated adult motor vehicle (MV) occupants has narrowed. Vast improvements have been made in strengthening laws and restraint use in front-, but not rear-seated occupants suggesting there may be value in expanding the science on rear-seat safety. Methods. A linked 2016–2017 hospital and MV crash data set, the Crash Outcomes Data Evaluation System (CODES), was used to compare characteristics of front-seated (n = 115,939) and rear-seated (n = 5729) adults aged 18 years and older involved in a MV crash in New York State (NYS). A primary enforced seat belt law existed for front-seated, but not rear-seated occupants. Statistical analysis employed SAS 9.4. Results. Compared to front-seated occupants, those rear-seated were more likely to be unrestrained (21.2% vs. 4.3%, p < 0.0001) and to have more moderate-to-severe injury/death (11.9% vs. 11.3%, p < 0.0001). Compared to restrained rear-seated occupants, unrestrained rear-seated occupants had higher moderate-to-severe injury/death (21.5% vs. 7.5%, p < 0.0001) and 4-fold higher hospitalization. More than 95% of ejections were unrestrained and had 7-fold higher medical charges. Unrestrained occupants’ hospital stays were longer, charges and societal financial costs higher. Conclusions. These findings extend the science of rear-seat safety in seriously injured rear-seated occupants, document increased medical charges and support the need to educate consumers and policy makers on the health and financial risks of adults riding unrestrained in the rear seat. The lack of restraint use in adult rear-seated motor vehicle occupants consumes scarce health care dollars for treatment of this serious, but largely preventable injury.

Seat belt use and cardiac arrest immediately after motor vehicle collision: Nationwide observational study

“…Injury to the high spinal cord could lead to cardiac arrest [ 27 ], and seat belts are reported to reduce cervical spine injury [ 9 ]. The results of this study are consistent with those of other studies on the preventive effect of seat belts on mortality and disability [ 8 , 10 , 28 , 29 ].…”

Fatal Motor Vehicle Crashes in Upstate and Long Island New York: The Impact of High Visibility Seat Belt Enforcement on Multiple Risky Driving Behaviors

“…Despite nearly five decades of preventive measures aimed at improving seat belt wearing, lack of use continues to be a leading factor in crash fatality for both the front and rear seats [1][2][3][4][5][6]. The National Highway Traffic Safety Administration (NHTSA) has piloted several initiatives, including a high visibility enforcement program known as Click It or Ticket to raise restraint (seat belt wearing) rates [6].…”

“…Despite accomplishing high daytime observed front-seat restraint rates, serious crashes, particularly fatal crashes, have demonstrated much lower restraint use in NY and nationally [3,8]. This uneven use of restraints is a contributing factor in many of the deaths of approximately 1100 New Yorkers each year.…”