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Direct medical charges of all parties in teen-involved vehicle crashes by culpability
  1. Corinne Peek-Asa1,
  2. Ling Zhang2,
  3. Cara J Hamann3,
  4. Elizabeth O'Neal4,
  5. Jingzhen Yang5
  1. 1 Office of Research Affairs and Department of Epidemiology, University of California, San Diego, San Diego, CA, USA
  2. 2 Department of Biostatistics, University of Iowa, Iowa City, IA, USA
  3. 3 Department of Epidemiology, University of Iowa, Iowa City, IA, USA
  4. 4 Department of Psychological and Brain Sciences, The University of Iowa, Iowa City, Iowa, USA
  5. 5 Center for Injury Research and Policy, Nationwide Children's Hospital, Columbus, Ohio, USA
  1. Correspondence to Dr Corinne Peek-Asa, Office of Research Affairs, University of California, San Diego, San Diego, CA 92135, USA; cpeekasa{at}


Background Motor vehicle crashes among teen drivers often involve passengers in the teen’s vehicle and occupants of other vehicles, and the full cost burden for all individuals is largely unknown. This analysis estimated direct hospitalisation and emergency department charges for teen-involved crashes by teen culpability, comparing charges for the teen driver, passengers and occupants of other vehicles.

Methods Probabilistic linkage was performed to link the Iowa police crash reports with Iowa emergency department and Iowa hospital inpatient data. Teen drivers aged 14–17 involved in a crash from 2016 through 2020 were included. Teen culpability was determined through the crash report and examined by teen and crash characteristics. Direct medical charges were estimated from charges through linkage to the Iowa hospital inpatient and the Iowa emergency department databases.

Results Among the 28 062 teen drivers involved in vehicle crashes in Iowa between 2016 and 2020, 62.1% were culpable and 37.9% were not culpable. For all parties involved, the inpatient charges were $20.5 million in culpable crashes and $7.2 million in non-culpable crashes. The emergency department charges were $18.7 million in teen culpable crashes and $6.8 million in teen non-culpable crashes. Of the $20.5 million total inpatient charges in which a teen driver was culpable, charges of $9.5 million (46.3%) were for the injured teen driver and $11.0 million (53.7%) for other involved parties.

Conclusions Culpable teen-involved crashes lead to higher proportions of injury and higher medical charges, with most of these charges covering other individuals in the crash.

  • teen drivers
  • culpability
  • vehicle crashes

Data availability statement

Data are available upon reasonable request.

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  • Contributors CP-A conceived the project. JY and CJH were principal investigators on parent funding. CP-A and CJH designed the study with expertise and input from EO'N and JY. CP-A and LZ developed the analytical strategy and LZ conducted the analyses. CP-A, CJH and LZ developed the linkage strategy. CP-A and LZ drafted the manuscript with revisions by CJH, EO'N and JY. CPA is the overall guarantor.

  • Funding This work was supported by the National Institutes of Health/National Institute of Neurological Disorders and Stroke (R01HD098176) and the Iowa Governor’s Traffic Safety Bureau (588DSA2019).

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.