University of Iowa Injury Prevention Research Center, 2195 Westlawn, Iowa City, IA 52242, USA.
University of Iowa Injury Prevention Research Center, 2195 Westlawn, Iowa City, IA 52242, USA; Department of Epidemiology, College of Public Health, University of Iowa, 145 North Riverside Drive, Iowa City, IA 52242, USA.
J Safety Res. 2021 Feb;76:83-89. doi: 10.1016/j.jsr.2020.12.001. Epub 2020 Dec 19.
Driver retirement and determination of fitness-to-drive are important aspects of reducing the risk of motor-vehicle collision for an older driver. A lack of information about the review process may lead to poor evaluation of drivers or an increased testing burden to referred drivers.
This paper evaluates the license review process for the state of Iowa. We evaluated data from January 2014 to January 2018 and described the source of referral, testing process, and ultimate license disposition. Cox proportional hazards for competing risk were used to determine the risk of having a change in restrictions on the license and the risk of license denial.
20,742 individuals were followed through the medical referral process. The most common source of referrals was licensing officials (39.7%). Drivers referred by licensing officials were less likely to be denied their license when compared to drivers from other sources (HR = 0.92 95%CI: 0.87-0.98); however, licensing official referrals were more likely to result in license restrictions compared to other sources (HR = 1.91, 95%CI: 1.82-2.00). Drivers referred by either law enforcement or a physician were more likely to ultimately have their license denied.
Physician and law enforcement referred the drivers most likely to have their license denied. A smaller proportion of drivers were referred by physicians and law enforcement compared to licensing officials. Practical Applications: Licensing agencies should work with physicians and law enforcement to identify drivers who may need a review of their license. Comprehensive tracking of all medical referrals for a driver's license review is important for individual states to understand the burden of their driver referral process and for identifying referral sources with a high proportion of referrals with no licensing change for targeted outreach and education.
驾驶员退休和驾驶能力评估是降低老年驾驶员发生机动车碰撞风险的重要方面。缺乏关于审查过程的信息可能导致对驾驶员的评估不佳，或者增加被转介驾驶员的测试负担。
本文评估了爱荷华州的驾照审查流程。我们评估了 2014 年 1 月至 2018 年 1 月的数据，描述了转介的来源、测试过程和最终驾照处理情况。使用竞争风险的 Cox 比例风险来确定驾照限制变化的风险和吊销驾照的风险。
20742 人通过医疗转介流程得到了随访。最常见的转介来源是发证官员（39.7%）。与其他来源的驾驶员相比，发证官员转介的驾驶员被吊销驾照的可能性更小（HR=0.92，95%CI：0.87-0.98）；然而，与其他来源相比，发证官员的转介更有可能导致驾照受限（HR=1.91，95%CI：1.82-2.00）。由执法人员或医生转介的驾驶员最终更有可能被吊销驾照。
医生和执法人员转介的驾驶员最有可能被吊销驾照。与发证官员相比，由医生和执法人员转介的驾驶员比例较小。发证机构应与医生和执法人员合作，确定可能需要审查驾照的驾驶员。综合跟踪所有驾驶员驾照审查的医疗转介对于各州了解其驾驶员转介流程的负担以及识别转诊来源具有重要意义，转诊来源的转诊比例高但驾照未发生变化，可针对这些来源进行有针对性的外联和教育。
