Statement of Purpose Teen drivers have the highest crash and injury rates among all drivers across the lifespan. These crashes involve passengers and occupants of other vehicles, and the full cost burden for all individuals is largely unknown. This analysis estimates direct medical costs for teen-involved crashes by teen culpability, comparing costs for the teen driver, passengers in the teen’s car, and occupants of other vehicles.
Methods/Approach Data were from the 2016–2017 Iowa CODES system, which links police crash reports, death certificates, inpatient, and emergency department records. Crashes involving drivers aged 14 through 17 were included. Other individuals involved in the crash were identified at the party-level of the crash report. Culpability was based on the crash report assigning a contributing cause to the teen driver. Direct medical costs were estimated from charges through linkage to the Iowa Hospital Inpatient and the Iowa Emergency Department Databases.
Results The teen driver was culpable in 59.0% of the 10,534 teen-involved crashes. The teen driver was injured in 20.2% of culpable crashes and 14.6% of non-culpable crashes. Among the individuals in the 8,228 (78.1%) crashes that involved other vehicles, 8.7% were injured when the teen was culpable and 3.2% when the teen was not (p<0.05). Total direct medical costs for teen-culpable crashes were $4.5 million for hospitalization and $9.7 million for emergency department visits; for non-culpable crashes were $2.9 million for hospitalizations and $5.9 million for emergency department visits (p<0.05). Overall, 78.7% of hospital costs and 58.5% of emergency department costs were for individuals other than the teen driver.
Conclusion Medical costs for culpable teen-involved crashes lead to higher proportions of injury and higher costs, with most of these costs covering other individuals in the crash.
Significance Teen-involved crashes lead to medical expenditures across the lifespan, indicating prevention as a priority.
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