Margolis Lewis H, Masten Scott V, Foss Robert D
Department of Maternal and Child Health, University of North Carolina, Chapel Hill, North Carolina 27599-7445, USA.
Traffic Inj Prev. 2007 Mar;8(1):35-8. doi: 10.1080/15389580600863005.
To mitigate the high risk of motor vehicle crashes for young beginning drivers, over 40 states and the District of Columbia have implemented graduated driver licensing (GDL) systems that gradually and systematically ease teen drivers into higher risk driving conditions. Evaluations of GDL programs using motor vehicle crash data have demonstrated marked declines in crashes. The objective of this study is to examine the association between the implementation of the North Carolina GDL program and the rate of hospitalization, as well as hospital charges, for 16-and 17-year-old drivers.
Data were obtained from the North Carolina Hospital Discharge Database for the 26 months before and 46 months after the December 1, 1997, implementation of the GDL program. ARIMA interrupted time series analyses were used to model monthly hospitalization rates, controlling for the hospitalization rates of 25-to 54-year-old drivers. ARIMA analyses were also used to determine whether changes occurred in monthly total hospital charges.
Among the 568 16-year-old hospitalized drivers, GDL was associated with a 36.5% decline in the hospitalization rate per population and a 31.2% decline in the total monthly driver hospitalization charges. Although a 12% reduction in the rate of hospitalizations was observed among the 615 17-year-old drivers, the analysis lacked sufficient power to be statistically reliable. No consistent change was observed in the 16-year-old driver total monthly hospital charges.
The North Carolina GDL program was associated with a marked decline in the rate of hospitalizations and hospital charges for 16-year-old drivers. Following the implementation of GDL, over $650,000 in hospital charges have been averted each year for 16-year-old drivers. Analyses suggest these reductions were primarily the result of reduced exposure rather than an improvement in teen driving.
为降低初出茅庐的年轻驾驶员发生机动车碰撞事故的高风险，40多个州和哥伦比亚特区已实施分级驾驶员执照（GDL）系统，该系统逐步且系统地让青少年驾驶员进入风险更高的驾驶环境。利用机动车碰撞事故数据对GDL项目进行的评估表明，事故率显著下降。本研究的目的是检验北卡罗来纳州GDL项目的实施与16岁和17岁驾驶员的住院率以及住院费用之间的关联。
数据取自北卡罗来纳州医院出院数据库，涵盖1997年12月1日GDL项目实施前的26个月和实施后的46个月。采用自回归积分滑动平均（ARIMA）中断时间序列分析对每月住院率进行建模，并对25至54岁驾驶员的住院率进行控制。ARIMA分析还用于确定每月总住院费用是否发生变化。
在568名16岁住院驾驶员中，GDL与每人口住院率下降36.5%以及每月驾驶员住院总费用下降31.2%相关。虽然在615名17岁驾驶员中观察到住院率下降了12%，但该分析缺乏足够的效力，无法在统计学上可靠。16岁驾驶员每月总住院费用未观察到一致变化。
北卡罗来纳州的GDL项目与16岁驾驶员的住院率和住院费用显著下降相关。GDL实施后，每年为16岁驾驶员避免了超过65万美元的住院费用。分析表明，这些减少主要是由于暴露减少，而非青少年驾驶技能的提高。
