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Can health public expenditure reduce the tragic consequences of road traffic accidents? The EU-27 experience

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Abstract

This study uses data for the EU-27 countries in the period 1999–2009 to estimate determinants of road traffic fatality rates. Controlling for country attributes and road safety policy variables, we examine the influence of variables related with the national health systems; the number of hospital beds per square kilometer, and the percentage of health expenditures over gross domestic product. We find evidence that the density of hospital beds contributes to the fall in traffic-related fatalities. Furthermore, the quality of general medical facilities and technology associated with increases in health expenditure may be also a relevant factor in reducing road traffic fatalities.

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Notes

  1. This concept refers to the care response timeframe after a RTA and is described as “crucial” by the literature for survival or reducing injuries (see Gitelman et al. 2012) (the first 60 min post-collision).

  2. Albalate [1], Albalate & Bel (2011), Dee [16] and Eisenberg [17] consider that this is the most appropriate dependent variable for assessing road traffic fatalities as the interpretation of policy variables is clearer.

References

  1. Albalate, D.: Lowering blood alcohol content levels to save lives: the European experience. J. Policy Anal. Manag. 27, 20–39 (2008)

    Article  Google Scholar 

  2. Albalate, D., Bel, G.: Motorways, tolls, and road safety: evidence from Europe. SERIEs: J. Span. Econ. Assoc. 3, 457–473 (2012)

    Article  Google Scholar 

  3. Anbarci, N., Escaleras, M., Register, C.: Traffic fatalities and public sector corruption. Kyklos 59, 327–344 (2006)

    Article  Google Scholar 

  4. Anwaar, A., Anastasopoulos, P., Ping Ong, G., Labi, S., Bin Islam, M.: Factors affecting highway safety, health care services, and motorization—an exploratory empirical analysis using aggregate data. J. Transp. Saf. Secur. 4, 94–115 (2012)

    Article  Google Scholar 

  5. Arroyo, A.S.M., García-Ferrer, A., De Juan Fernández, A., Sánchez-Mangas, R.: Lower posterior death probabilities from a quick medical response in road traffic accidents. J Appl. Stat. 40, 40–58 (2013)

    Article  Google Scholar 

  6. Bax, Ch.: Policy Instruments for Managing EU Road Safety Targets: Carrots, Sticks or Sermons? An Analysis and Suggestions for the USA. SWOV Institute for road safety research, publication R-2011-15, The Netherlands (2011)

    Google Scholar 

  7. Bentham, G.: Proximity to hospital and mortality from motor vehicle traffic accidents. Soc. Sci. Med. 10, 1021–1026 (1986)

    Article  Google Scholar 

  8. Bertrand, M., Duflo, E., Mullainathan, I.: How much should we trust differences-in-differences estimates? Q. J. Econ. 119, 249–275 (2003)

    Article  Google Scholar 

  9. Bishai, D., Quresh, A., James, P., Ghaffar, A.: National road casualties and economic development. Health Econ. 15, 65–81 (2006)

    Article  PubMed  Google Scholar 

  10. Braver, E.R., Trempel, R.E.: Are older drivers actually at higher risk of involvement in collisions resulting in deaths or non-fatal injuries among their passengers and other road users? Inj. Prev. 10, 27–32 (2004)

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  11. Buchmueller, T.C., Jacobson, M., Wold, Ch.: How far to the hospital? The effect of hospital closures on access to care. J. Health Econ. 25, 740–761 (2006)

    Article  PubMed  Google Scholar 

  12. Calvo, A.B., Marks, D.H.: Location of health care facilities: an analytical approach. Socio-econ. Plan. Sci. 7, 407–422 (1973)

    Article  Google Scholar 

  13. Castillo-Manzano, J.I., Castro-Nuño, M.: Driving licenses based on points systems: efficient road safety strategy or latest fashion in global transport policy? a world wide meta-analysis. Transp. Policy 21, 191–201 (2012)

    Article  Google Scholar 

  14. Cho, C.J.: An equity-efficiency trade-off model for the optimum location of medical care facilities. Socio-Econ. Plan. Sci. 32, 99–112 (1998)

    Article  Google Scholar 

  15. Cucic, S.: European Union health policy and its implications for national convergence. Int. J. Qual. Health Care 12, 217–225 (2000)

    Article  CAS  PubMed  Google Scholar 

  16. Dee, T.S.: Does setting limits save lives? The case of 0.08 BAC laws. J. Policy Anal. Manag. 20, 111–118 (2001)

    Article  Google Scholar 

  17. Eisenberg, D.: Evaluating the effectiveness of policies related to drunk driving. J. Policy Anal. Manag. 22, 249–274 (2003)

    Article  Google Scholar 

  18. Elvik, R., Vaa, T., Sorensen, M.: The Handbook of Road Safety Measures, 2nd ed. Emerald Group Publishing, Bingley, United Kingdom (2009)

  19. Elvik, R.: Speed limits, enforcement and health consequences. Annu. Rev. Public Health 33, 225–238 (2012)

    Article  PubMed  Google Scholar 

  20. European Commission (EC): Commission recommendation on support for an EU-Wide eCall Service in Electronic Communication Networks for the Transmission of In-Vehicle Emergency Calls Based on 112 (‘e-Calls’). SEC 1019 final, Brussels (2011)

  21. European Commission (EC): CARE database 2012. National Data of EU Road Fatalities. Annual Evolution Since 2001. Directorate General for Mobility and Transport, Brussels (2012)

  22. European Transport Safety Council (ETSC): Roadmap to a single European Transport Area—Towards a Competitive and Resource Efficient Transport System. ETSC response to the European Commission White Paper, Brussels (2011)

  23. García-Ferrer, A., De Juan, A., Poncela, P.: The relationship between road traffic accidents and real economic activity in Spain: common cycles and health issues. Health Econ. 16, 603–626 (2007)

    Article  PubMed  Google Scholar 

  24. Gitelman, V., Auerbach, K., Doveh, E.: Development of road safety performance indicators for trauma management in Europe. Accid. Anal. Prev. (2012). doi:10.1016/j.aap.2012.08.006

  25. Grimm, M., Treibich, C.: Determinants of road traffic crash fatalities across Indian States. Health Econ. (2012). doi:10.10002/hec.2870

  26. Herrero Blanco, C., Abellán Perpiñán, J.M., Cubí Mollá, P., Martínez Pérez, J.E., Méndez Martínez, I., Sánchez Martínez, F.I.: Siniestralidad vial en España y la Unión Europea (1997–2007). Fundación BBVA, Spain (2011)

    Google Scholar 

  27. Hitiris, T.: Health care expenditure and integration in the countries of the European Union. Appl. Econ. 29, 1–6 (1997)

    Article  Google Scholar 

  28. Humphreys, J.S.: A political economy approach to the allocation of health care resources: the case of remote areas of Queensland. Aust. Geogr. Stud. 23, 222–242 (1985)

    Article  Google Scholar 

  29. Jamroz, K.: The impact of road network structure and mobility on the national traffic fatality rate. Procedia-Soc. Behav. Sci. 54, 1370–1377 (2012)

    Article  Google Scholar 

  30. Kopits, E., Cropper, M.: Traffic fatalities and economic growth. Accid. Anal. Prev. 37, 169–178 (2005)

    Article  PubMed  Google Scholar 

  31. Langford, J., Hakamies-Blomqvist, L., Methorst, R.: Older drivers do not have high crash risk—a replication of low mileage bias. Accid. Anal. Prev. 38, 574–578 (2006)

    Article  PubMed  Google Scholar 

  32. Levin, A., Lin, C.F., Chia-Shang, J.C.: Unit root tests in panel data: asymptotic and finite sample properties. J. Econ. 108, 1–24 (2002)

    Article  Google Scholar 

  33. Li, H., Graham, D.J., Majumdar, A.: The effects of congestion charging on road traffic casualties: a causal analysis using difference-in-difference estimation. Accid. Anal. Prev. 49, 366–377 (2012)

    Article  PubMed  Google Scholar 

  34. Maio, R.F., Green, P.E., Becker, M.P., Burney, R.E.: Rural motor vehicle crash mortality: the role of crash severity and medical resources. Accid. Anal. Prev. 24, 631–642 (1992)

    Article  CAS  PubMed  Google Scholar 

  35. Nixon, J., Ulmann, Ph: The relationship between health care expenditure and health outcomes. Eur. J. Health Econ. 7, 7–18 (2006)

    Article  PubMed  Google Scholar 

  36. Noland, R.B.: Traffic fatalities and injuries: the effect of changes in infrastructure and other trends. Accid. Anal. Prev. 35, 599–611 (2003)

    Article  PubMed  Google Scholar 

  37. Noland, R.B.: Medical treatment and traffic fatality reductions in industrialized countries. Accid. Anal. Prev. 35, 877–883 (2003)

    Article  PubMed  Google Scholar 

  38. Noland, R.B., Quddus, M.A.: Improvements in medical care and technology and reductions in traffic-related fatalities in great Britain. Accid. Anal. Prev. 36, 103–113 (2004)

    Article  PubMed  Google Scholar 

  39. Orsi, Ch., Bertuccio, P., Morandi, A., Levi, F., Bosetti, C., La Vecchia, C.: Trends in motor vehicle crash mortality in Europe, 1980–2007. Saf. Sci. 50, 1009–1018 (2012)

    Article  Google Scholar 

  40. Pammolli, F., Riccaboni, M., Magazzini, L.: The sustainability of European health care systems: beyond income and aging. Eur. J. Health Econ. 13, 623–634 (2012)

    Article  PubMed  Google Scholar 

  41. Przywara, B.: Projecting Future Health Care Expenditure at European Level: Drivers, Methodology and Main Results. European Economy, Economic Papers 417, July. Economic and Financial Affairs, European Commission, Brussels (2010)

  42. Rahman, S., Smith, D.K.: Use of location-allocation models in health service development planning in developing nations. Eur. J. Oper. Res. 123, 437–452 (2000)

    Article  Google Scholar 

  43. Racioppi, F., Eriksson, L., Tingvall, C., Villaveces, A.: Preventing Road Traffic Injury: A Public Health Perspective for Europe. World Health Organization (WHO) Regional office for Europe, Denmark (2004)

    Google Scholar 

  44. Sánchez-Mangas, R., García-Ferrer, A., De Juan, A., Martín Arroyo, A.: The probability of death in road traffic accidents. How important is a quick medical response? Accid. Anal. Prev. 42, 1048–1056 (2010)

    Article  PubMed  Google Scholar 

  45. Smith, I.: Road fatalities, modal split and Smeed’s law. Appl. Econ. Lett. 6, 215–217 (1999)

    Article  Google Scholar 

  46. Threlfall, M.: European social integration: harmonization, convergence and single social areas. J. Eur. Soc. Policy 13, 121–139 (2003)

    Article  Google Scholar 

  47. Wilde, E.TY.: Do emergency medical system response times matter for health outcomes? Health Econ. (2012). doi:10.1002/hec.2851

  48. Wörz, M., Busse, R.: Analysing the impact of health-care system change in the EU member states-Germany. Health Econ. 14, S133–S149 (2005)

    Article  PubMed  Google Scholar 

  49. Yee, W.Y., Cameron, P.A., Bailey, M.J.: Road traffic injuries in the elderly. Emerg. Med. J. 23, 42–46 (2006)

    Article  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

The authors are grateful to Prof. Wolfgang Greiner and the two anonymous reviewers for their helpful comments.

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Correspondence to Xavier Fageda.

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Castillo-Manzano, J.I., Castro-Nuño, M. & Fageda, X. Can health public expenditure reduce the tragic consequences of road traffic accidents? The EU-27 experience. Eur J Health Econ 15, 645–652 (2014). https://doi.org/10.1007/s10198-013-0512-1

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  • DOI: https://doi.org/10.1007/s10198-013-0512-1

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