vittime della strada e costi sociali · vittime della strada e costi sociali il costo sociale medio...
TRANSCRIPT
S.C. Medicina Legale
Azienda USL2 Lucca
Direttore: Prof. Massimo Martelloni
Vittime della strada e
costi sociali
Dr. Stefano D’Errico
Siena, 11 ottobre 2014
Le dimensioni del
problema
Conseguenze
economiche del
sinistro
I costi socialii costi sanitari
Considerazioni
finali
Le dimensioni del problema
“Background information”
Deaths from traffic injury are a very significant part of the problem
accounting for 25% of all deaths from injury (WHO 2004).
Road traffic injuries account for almost 1.2 milion of deaths a year
around the world and for 20-50 million injuries or disabilities.
In 2005, 41,600 people were killed in road traffic accidents in the EU
(European Traffic Safety Council 2007).
The true number of people injured in road
accidents is unknown, but it is known that it is
considerably higher than the officially recorded
number
“…Data from the
Global Burden Disease
2002 project show that
almost a quarter of
those injured severely
enough to require
admission to a health
facility sustain a
traumatic brain injury;
10% suffer open wounds,
such as lacerations, and
nearly 20% experience
fractures to the lower
limbs…”.
“…the estimated annual costs (both
direct and indirect) of road crash
injury in European Union (EU)
countries alone, which contribute 5% to
the global death toll, exceed €180
billion (US$ 207 billion)…”.
“…For the United States of America,
the human capital costs of road traffic
crashes in 2000 were estimated at
US$ 230 billion…”.
Le dimensioni del problema
“Background information”
“…In economic terms, the cost of
road crash injuries is estimated at
roughly 1% of gross national product
(GNP) in low-income countries, 1.5%
in middle- income countries and 2%
in high-income countries…”.
Conseguenze economiche del sinistro
ACI 2008
Conseguenze economiche del sinistro
“…a slightly injured
individual suffered bodily
injury requiring medical aid
that did not exceed 24 h of
hospitalization.
A seriously injured person had
to stay in the hospital at least
24 h as a consequence of the
accident.
A fatality is a person who died
within 24 h as a consequence
of the accident …”.
I costi sociali degli
incidenti stradali
costituiscono una stima
del danno economico
subito dalla società a
causa di tali eventi.
Il danno economico non è (soltanto)
rappresentato da una spesa diretta sostenuta
dalla società, ma è la quantificazione
economica degli oneri che, a diverso titolo,
gravano sulla stessa a seguito delle
conseguenze causate da un incidente stradale
2007
I costi sociali
Vittime della strada e costi sociali
Il Costo sociale medio per incidente
mortale rappresenta il danno
economico subito dalla società, e
derivante dall’evento incidente stradale
mortale. Si tratta della quantificazione
economica degli oneri principali che a
diverso titolo gravano sulla società per
un incidente mortale.
Il Costo sociale medio per incidente
grave rappresenta, invece, il danno
economico subito dalla società, e
derivante dall’evento incidente stradale
non mortale in cui sia stato coinvolto
almeno un “ferito grave”, ossia una
persona che ha subito delle lesioni gravi
al proprio corpo a seguito dell’incidente.
costo sociale
medio
Incidente mortale
Incidente grave
CM / CF CG
Mancata
produttività
Danno non patrimoniale
Costi sanitari
Costi amministrativi
Danno patrimoniale
Nei costi sanitari sono comprese:
• le spese sostenute in regime di
ricovero;
• i costi del pronto soccorso;
• i costi del soccorso in autoambulanza;
• la gestione della cronicità.
In base ai dati ISTAT, le spese sanitarie
totali annuali nel 2009 ammontavano a
circa 612 milioni di euro, mentre nel
2008 erano pari a circa 621 milioni di
euro.
I costi sanitari
“…Removing unnecessary
tests would reduce costs,
but the basic solution is to
increase preventive
measures against traffic
accidents and driver
education must be
improved…”
“…5.27 million people had sustained non-fatal road traffic injuries in 2000,
87% of which were considered “minor”, according to the maximum injury
severity scale. These injuries resulted in medical costs of US$ 31.7 billion,
placing a huge burden on health care services and individual
finances.
Studi a confronto
Sulla base delle stime di costo
sociale medio per incidente
mortale e per incidente grave è
possibile calcolare il costo
dell’incidentalità, inteso come il
danno economico complessivo
subito dalla società e causato
dall’incidentalità stradale.
Il costo totale dell’incidentalità
Il costo sociale dell’incidentalità
Valutazione delle conseguenze
economiche degli incidenti stradali
Il costo totale dell’incidentalità
Human capital approach
2012
“Willingness to pay approach”La stima della somma che sarebbero disposte a
pagare le persone per evitare un incidente stradale.
“…In the case of serious injury, the impact on the lives of crash victimscan involve extended or evenlifelong impairment or physicalpain, which can interfere with or prevent even the most basic living
functions…”
Assessing the value of these impacts provides a more complete
basis for quantifying the harmful impacts of motor vehicle crashes
on society.
“…However, in cases of serious injury or death, medical
care cannot fully restore victims to their pre-crash status
and human capital costs fail to capture the
relatively intangible value of lost quality-of-
life that results from these injuries…”
The Fédération Européenne des
Victimes de la Route (FEVR)
conducted a comprehensive study in
Europe of the physical, psychological
and material damage suffered by
victims and their families subsequent to
road crashes.
The results showed that 90% of the
families of those killed and 85% of
the families of those disabled
reported a significant permanent
decline in their quality of life, and
in half of the cases the
consequences were especially
severe.
il QALY LOSS
Estimating
the cost to
society of
road crashes
is important
for several
reasons.
First, it is
essential for
raising
awareness
of the
seriousness
of road
crashes as a
social
problem.
“…Since the social cost of road traffic crashes is a
reflection of the social benefits of reducing crashes
through safety interventions, scientific
assessments of the costs enables priorities
between different interventions to be made,
using cost–benefit methods…”.
Considerazioni finali
• discovering, through injury surveillance and
surveys, as much as possible about all aspects of road
crash injury – by systematically collecting data on the
magnitude, scope, characteristics and consequences
of road traffic crashes;
• researching the causes of traffic crashes and
injuries, and in doing so trying to determine: —
causes and correlates of road crash injury, — factors
that increase or decrease risk factors that might be
modifiable through interventions;
• exploring ways to prevent and reduce the
severity of injuries in road crashes – by designing,
implementing, monitoring and evaluating appropriate
interventions;
• helping to implement, across a range of settings,
interventions that appear promising, especially in the area
of human behaviour, disseminating information on the
outcomes, and evaluating the cost-effectiveness of these
programmes;
• working to persuade policy-makers and decision-
makers of the necessity to address injuries in general
as a major issue, and of the importance of adopting
improved approaches to road traffic safety;
• translating effective science-based information into
policies and practices that protect pedestrians, cyclists and
the occupants of vehicles.
medicina legale
