vittime della strada e costi sociali · vittime della strada e costi sociali il costo sociale medio...

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

grazie per

l’attenzione s.derrico@usl2.toscana.it