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ANN ARBOR,
MI - Motorcycle riders who crash without a helmet rack up far
larger hospital bills than those whose heads were protected in a
crash, a new University of Michigan
study finds.
From the emergency
room door to the trauma center to the rehabilitation unit, the authors
report, care for unhelmeted crash victims cost substantially more
and kept patients in the hospital longer than care for patients
who wore helmets.
At the same
time, those injured while riding without a helmet were somewhat
less likely to be covered by insurance that could pay for their
care, according to the paper in the September issue of the Journal
of Trauma. The results also confirm earlier findings that
riders without helmets were younger, suffered more head and neck
injuries, and had a higher overall injury severity score.
The study analyzed
data for 216 motorcycle crash victims brought to the U-M
Health System's Trauma Burn Center between 1996 and 2000. Forty-two
of them, or 19 percent, were not wearing a helmet when they crashed
-- despite Michigan's mandatory helmet law. The detailed analysis
was made possible by a unique medical records database that captures
diagnoses and charges for U-M patients.
On average,
helmet use led to average hospital costs that were about 20 percent,
or $6,000, less than costs for those who didn't wear helmets. For
patients who were treated on an inpatient rehabilitation floor at
the U-M after leaving the trauma unit, average costs for unhelmeted
riders were nearly twice those of helmeted riders.
"This
adds further evidence to the argument that we need helmet laws for
every rider in every state, not to infringe on personal freedom,
but to improve safety and reduce costs for everyone," says
Mary Margaret Brandt, M.D. an assistant professor in the U-M
Medical School's Department of Surgery and a trauma surgeon
at the Trauma Burn Center. "Until that happens, it shows that
those who ride without helmets should pay higher insurance premiums,
as smokers and other high-risk groups do."
The U-M researchers'
approach differs from that of previous studies that tallied health
care costs for every victim of motorcycle crashes in a given state
-- including those who died at the scene or before they reached
the hospital, and therefore lowered the overall average cost of
care.
In 2000, 2,862
motorcyclists died and approximately 58,000 were injured in highway
crashes in the United States, according to the National Highway
Traffic Safety Administration. Unhelmeted riders are 40 percent
more likely to suffer a fatal head injury and 15 percent more likely
to sustain a nonfatal injury than those who wear helmets, NHTSA
reports.
Despite the
evidence supporting helmet use as a means of reducing injuries,
deaths, health care costs and disability, three U.S. states have
no helmet law, and another 27 have laws that only require helmets
for certain riders, mainly minors.
Since the U.S.
Congress lifted federal sanctions in 1995, five states have weakened
their helmet laws. And in the past year, there have been campaigns
to weaken or repeal the helmet laws of 10 states, including Michigan.
The state's latest repeal attempt passed the state House in May.
The U-M study
found that 81 percent of the patients admitted to the U-M Trauma
Burn Center from motorcycle crashes in the study period had worn
a helmet, even though Michigan state police surveys from 1997 to
1999 found that 96 percent of people involved in motorcycle crashes
wore helmets.
The average
age of the helmeted riders was 37 years, compared with 32 years
for unhelmeted riders. Ninety-two percent of all the patients studied
were male. The injury severity score for each patient was calculated,
and it correlated with the length of the patient's stay in the Trauma
Burn Center and with the cost of the patient's hospitalization.
The injury severity score for head and neck injuries was significantly
higher for patients who had not worn helmets.
Patients who
had worn helmets during their crash had average hospital costs of
$31,158, as opposed to $37,317 for those who hadn't worn a helmet.
Ninety-two percent of the helmeted riders were insured, while only
86 percent of unhelmeted riders were.
The researchers
tracked 23 patients from the larger group who were admitted to the
hospital-based rehabilitation unit run by the U-M
Physical Medicine and Rehabilitation Department. Average costs
for unhelmeted riders ran $43,053, compared with $23,201 for helmeted
riders.
Brandt notes
that the UMHS Data Warehouse, which has tracked all cost data for
U-M inpatients since mid-1996, made the current research possible.
She speculates that outpatient costs for unhelmeted patients, which
cannot be accurately be tracked because many patients return to
their home town after treatment at the U-M Trauma Burn Center, may
be even higher.
"These
differences in costs create a financial burden, incurred by the
patient, which weighs on the health care system and society,"
she says. "The price for personal freedom is not isolated to
the individual motorcyclist, but is paid by the entire community."
Besides Brandt,
the paper's authors include Karla S. Ahrns, RN, a nurse in the Trauma
Burn Center; and current and former U-M surgeons Cynthia A. Corpron,
M.D., Glen Franklin, M.D. and Wendy L. Wahl, M.D.
For more information
on motorcycle helmet issues, visit:
National Highway Traffic Safety Administration: www.nhtsa.dot.gov
Insurance Institute for Highway Safety: www.hwysafety.org/safety_facts/state_laws/helmet_use.htm
Written
by: Kara Gavin
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