Health care utilization and charges following the enactment of the 2007 Graduated Drivers Licensing Law in Massachusetts

Naveen F Sangji; Elie P Ramly; Haytham M A Kaafarani; Raghu Seethala; Toby Raybould; Carlos A Camargo Jr; George Velmahos; Peter T Masiakos; Jarone Lee

doi:10.1016/j.jpedsurg.2015.06.004

Health care utilization and charges following the enactment of the 2007 Graduated Drivers Licensing Law in Massachusetts

J Pediatr Surg. 2015 Oct;50(10):1791-6. doi: 10.1016/j.jpedsurg.2015.06.004. Epub 2015 Jun 20.

Authors

Naveen F Sangji¹, Elie P Ramly², Haytham M A Kaafarani³, Raghu Seethala⁴, Toby Raybould⁵, Carlos A Camargo Jr⁶, George Velmahos⁷, Peter T Masiakos⁸, Jarone Lee⁹

Affiliations

¹ Department of Surgery, Division of Trauma, Emergency Surgery, and Surgical Critical, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA. Electronic address: nsangji@partners.org.
² Department of Surgery, Division of Trauma, Emergency Surgery, and Surgical Critical, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA. Electronic address: eramly@partners.org.
³ Department of Surgery, Division of Trauma, Emergency Surgery, and Surgical Critical, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA. Electronic address: hkaafarani@partners.org.
⁴ Department of Emergency Medicine, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA. Electronic address: rseethala@partners.org.
⁵ Department of Surgery, Division of Trauma, Emergency Surgery, and Surgical Critical, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA. Electronic address: traybould@partners.org.
⁶ Department of Emergency Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA. Electronic address: ccamargo@partners.org.
⁷ Department of Surgery, Division of Trauma, Emergency Surgery, and Surgical Critical, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA. Electronic address: gvelmahos@partners.org.
⁸ Department of Pediatric Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA. Electronic address: pmasiakos@partners.org.
⁹ Department of Surgery, Division of Trauma, Emergency Surgery, and Surgical Critical, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA; Department of Emergency Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA. Electronic address: lee.jarone@mgh.harvard.edu.

PMID: 26235531
DOI: 10.1016/j.jpedsurg.2015.06.004

Abstract

Background: Graduated Drivers Licensing (GDL) programs phase in driving privileges for teenagers. In 2007, Massachusetts implemented a stricter version of the 1998 GDL law, with increased fines and education. This study evaluated the impact of the law on motor vehicle crash (MVC)-related health care utilization and charges.

Methods: Massachusetts government and US Census Bureau data were analyzed to compare the rates of MVC-related emergency department (ED) visits and hospital charges before (2002-2006) and after (2007-2011) the 2007 GDL law. Three driver age groups were studied: 16-17 (evaluating the law effect), 18-20 (evaluating the sustainability of the effect), and 25-29 years old (control group).

Results: MVC-related ED visits per population decreased after the law for all three age groups (16-17: 2326 to 713; 18-20: 2110 to 1304; 25-29: 1694 to 1228; per 100,000, p<0.001), but the decrease was greater amongst teenagers (16-17: -69%; 18-20: -38%) compared to the control group (-27%); p<0.001. MVC-related hospital charges per population also decreased for teenagers but increased for the control group (16-17: $2.70 m to $1.45 m; 18-20: $3.52 m to $2.26 m; 25-29: $1.86 m to $1.92 m; per 100,000, p<0.001).

Conclusions: The 2007 GDL law in Massachusetts was associated with significant decreases in MVC-related health care utilization and hospital charges among teenage drivers.

Keywords: Graduated Drivers Licensing laws; Health care costs; Health care utilization; Massachusetts; Teenage drivers.

MeSH terms

Accidents, Traffic / statistics & numerical data
Adolescent
Adult
Automobile Driving / legislation & jurisprudence*
Emergency Service, Hospital / economics*
Emergency Service, Hospital / statistics & numerical data*
Hospital Charges*
Humans
Licensure / legislation & jurisprudence*
Massachusetts / epidemiology
Young Adult