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The cost of road injuries in France

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THE COST OF ROAD INJURIES IN FRANCE

Laurent Carnis*, Jean-Louis Martin** and Dominique Mignot** *Université Paris-Est, Ifsttar, AME, Dest

**Université de Lyon ; Ifsttar, TS2, Umrestte

Cité Descartes 14-20 Boulevard Newton, 77447 Marne-le-Vallée, France Phone: + 33 (0)1 81 66 86 20,

Mail: laurent.carnis@ifsttar.fr; jean-louis.martin@ifsttar.fr; dominique.mignot@ifsttar.fr The expected total cost of accidents for France amounted between 37.5 and 50 billion Euros in 2014. It would represent between 1.5 % and 2 % of the Gross Domestic Product (GDP). At the European level, the total costs of crashes vary between 0.4% and 4.1% of the GDP and the total costs related to serious injuries vary between 0.04% of the GDP for Ireland and 2.7% for Poland, according figures advanced by a recent European research project (Safetycube).

For France, the total costs of serious injury crashes/serious injuries is estimated at 10.5 billion Euros in 2014 and the total costs of slight injury crashes/slight injuries is estimated at 0,7 billion Euros. However,, the monetary values used for valuing the different types of injury are estimated by applying a simple percentage of the Statistical Value Of Life (VOSL) (3 billion Euros per fatality, 2010 value), aligned with the HEATCO or CEMT recommendations.

Consequently, in France, there is no real and accurate knowledge of the amount of costs for the different components of the total costs of road injuries and there is a relative uncertainty concerning the assessment of that cost. However, that figure is quite crucial, because it could help the public decision maker in deciding to implement or not some road safety countermeasures, but also in establishing some hierarchies among the efficient road safety measures.

Aim: That contribution proposes first a state of the art related to the estimation of the cost of the road injuries for the French case, the different components, and the potential sources of information and methods of estimation and second few methodological propositions in order to better identify the costs of injuries. It would sum-up the crucial information dealing with the cost of injuries, and especially the personal damage. In some way, it will propose for the first time in France a survey and a critical analysis of the most recent information available on that question. It would provide additional information collected from on-going projects.

Method: The collection of information will be based on a critical survey approach of the scientific and grey literature published on that issue. This approach will make possible to show both the evolution of methods for estimating the cost of road accident injuries and the value estimated. Some addition statistical information issued from recent researches will be presented for highlighting some important issues, which can be hidden through too general statistics. European and international literature on the subject will help us to specify which components are to be taken into account and how, in order to better know the cost of road injuries. Of course, this will be also reported to an analysis of existent databases in both fields of Health field and Road Safety field in France, in order to provide applicable recommendations.

Results: The costs of road accident injuries appear as being a difficult issue to grasp. Information is not centralized and fragmented among different stakeholders. The different sources of information highlight only some parts of the costs of accident or some components, never provide a full account of

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the total costs. Paid damages by insurance companies provided then different figures than the collective value used by the government for similar categories of victims. Other sources provide with some information on medical costs or loss of revenues, for example, showing a huge variability among the victims and the typologies of damage. Consequently, it is quite difficult to have nowadays a clear and accurate picture of the cost of road injuries and of the full cost of a road accident in France. Nevertheless, different results and methods issued form ongoing projects in which authors are involved allow proposing new methods to evaluate the components of the cost of road injuries. This will be applied to existent databases and particularly Trauma Registry in Rhône Department including all road crashes injuries on the area of the Rhône Department. This first estimation of the cost of road injuries on that area would then allow us to propose a method for a calculation at national level. Thus, two main results should be provided:

• Based on “Rhône Trauma Registry” Data and WP7.2 SafetyCube’s methodology, estimation of the cost of DALY/QALY, years of life lost and years with a disability, calculated according to a hierarchical typology of injuries;

• Based on hospital data from PMSI (medicalization program of information systems) evaluation of monetary costs of medical treatments and care during hospitalization.

Conclusion: That paper sustains that there is no one way for answering the question of the assessment of the cost of road accident injuries. We propose to reformulate the question by raising first critical issues like: who bear the cost, when and what types of costs. Moreover, some further research is required for having a more detailed stakes related with road accident injuries. A first application to the Rhône Department would give ideas and tools for a calculation at national level in France.

Bibliography

Achit, H. and L. Carnis (2014) Physical Impairment and Medical Care Spending for Road Crash Victims. Securitas Vialis 18: 36-53.

Baumstark L., Dervaux B., Treich N. (2013) « Eléments pour une révision de la valeur statistique de la vie humaine » in L’évaluation socio-économique en période de transition, Rapport de la Commission présidée par E. Quinet, Rapports et Documents, Tome 2 : contributions, Paris : Commissariat général à la stratégie et à la prospective.

Baumstark L., Rochaix L. (2013) « Les enjeux du calcul économique dans le secteur de la santé » in

L’évaluation socio-économique en période de transition, Rapport de la Commission présidée par E. Quinet,

Rapports et Documents, Tome 2 : contributions, Paris : Commissariat général à la stratégie et à la prospective

Boiteux M. (2001) Transports: choix des investissements et coût des nuisances, Commissariat Général du Plan Paris: La Documentation Française, 323 p.

Boiteux M, Baumstark L. (2001) Transports: choix des investissements et coût des nuisances, Commissariat Général du Plan, Paris: La Documentation Française, 323 p.

Boiteux M., Mathieu M., Halaunbrenner G. (1994) Transport : pour un meilleur choix des investissements, Commissariat Général du Plan, Paris : La Documentation Française, 132 p.

Carnis L et Mignot D (éds) (2010) Les Cahiers Scientifiques du Transport, n° 57/2010, numéro spécial « Economie de la sécurité routière : définition, connaissance et enjeux ».

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Carnis L et Mignot D. (éd.) (2012), Pour une économie de la sécurité routière. Emergence d’une approche pour

l’élaboration de politiques publiques, Paris, Economica, 198p.

DGITM/MEDDE, note technique relative à l’évaluation des projets de transport (DGITM), 27 juin 2014

Haagsma, J. A., N. Graetz, et al. (2016) The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013. Injury Prevention 22(1): 3-18

Haagsma, J. A., C. Maertens de Noordhoot, et al. (2015) Assessing disability weights based on the responses of 30,660 people from four European countries. Population Health Metrics 13: 10.

Haagsma, J. A., S. Polinder, et al. (2012) Improved and standardized method for assessing years lived with disability after injury. Bulletin of the World Health Organization 90: 513-521.

Lapostolle, A., B. Gadegbeku, et al. (2009) The burden of road traffic accidents in a French Departement: the description of the injuries and recent changes. BMC Public Health 9: 386.

Quinet E. éd., 2000, Economic Evaluation of Road Traffic Safety Measures, CEMT Round Table 117, 167 p.

Quinet E. (2013) L’évaluation socio-économique en période de transition, Rapporteur général : L. Baumstark, Rapports et Documents, Commissariat général à la stratégie et à la prospective, Juin 2013

Wijnen Wim (2013), Social Costs of Road Crashes: An International Analysis, 16th Road Safety on Four Continents Conference, Beijing, China 15-17 May 2013.

References

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