Written by  Oct 24, 2016 - 2424 Views

Estimated Cost of National Road Traffic Injuries

 Road traffic injuries in Iran waste a major part of the national wealth and output in the country. By spending a small part of this cost on road immunization plans and programs the waste can be avoided to a great extent; on the other hand by preventing such waste a significant help can be rendered to the economic growth. In other words, making small investment on improvement of road safety in Iran will result in the return of outstanding capital to such extent that it will justify implementation of each plan, no matter how ambitious, in this regard. Therefore, growth of technology, education and infrastructures, will be in line with the improvement of traffic safety as a basic factor in the development of the country.

In this project, with the focus on the burden of health resulting from traffic injuries in Iran, efforts have been aimed to seek the quantitative amount or, in other words, its economic burden. By dividing the costs into two direct and indirect costs, the objective and mental dimensions of this economic burden will be quantified. For this purpose, efforts have been made to use a combination of the experiences available in Iran, the international directives and experiences of developed countries in this project. By using these experiences and the collected data during this study, the elements of the cost and their amount have been achieved in the calendar year 1390 (2011/2012) as shown in the Table (1-7).

This estimated cost has been made for the entire people injured in traffic crashes throughout the country and in the three classifications of main category, elements of cost and details of the costs. In this table and figure (1-7), it is seen that medical costs in the main category, the lost output among elements of the cost and post-release costs among details of the cost have allocated the highest share of the traffic injuries cost to themselves.

Part II: Estimated cost of road traffic injuries

Table 1-7: Road traffic injuries cost in Iran in 1390 (2011/2012)

Main Category Elements of Cost
Heading Cost (Billion IRR) Cost Ratio Heading Cost (Billion IRR)
Medical costs 46/237/520 41.53 Pre-hospital costs 1/022/692
Treatment costs 15/738/828
Post-release costs 29/476/000
Lost output 3/499/172 31.43 Lost national output 3/499/172
Indirect costs 30/107/727 27.04 Pain, grief and suffering (reduced quality of life) 2/9846/740
Reduced functional capacity 260/987
  34/954/788  ------- Willingness to pay 34/954/788
The total cost of road traffic injuries using human capital (medical costs, lost output and reduced quality of life):111,342 billion IRR
           
Cost ratio Heading Cost (Billion IRR) Cost Ratio (%)
0.919 Emergency 115 917/445 0.82
Firefighting and Red Crescent 55/508 0.05
Transfer by private car 49/739 0.04
14.136 Hospital treatment (public payment) 3/713/220 3.33
Hospital treatment (private payment) 11/987/000 10.77
Non-hospital treatment 38/608 0.03
26.473 Post-release costs 29/476/000 26.47
31.432 Caused by casualties 22/822/181 20/50
Caused by physical disabilities 12/174/991 10.93
26.806 Pain, grief and suffering (reduced quality of life) caused by casualties 9/496/880 8.53
Pain, grief and suffering (reduced quality of life) caused by physical disabilities 20/349/860 18.28
0.234 Caused by injuries 260/987 0.23
   -------- Total value of lost lives 34/954/788    -----

Medical costs 42%

Indirect costs 27%

Lost output 31%

Pre-hospital costs 1%

Treatment costs 14%

Post-release costs 27%

Pain, grief & suffering (reduced quality of life) 27%

Lost national output 31%

Figure 1-7: Share of each cost element of traffic injuries in Iran in 1390 (2011/2012)

Part II: Estimated cost of road traffic injuries

Emergency 115

Firefighting and Red Crescent

Transfer by private car

Hospital treatment (public payment)

Hospital treatment (private payment)

Non-hospital treatment

Post-release costs

Lost national output caused by casualties

Lost national output caused by physical disabilities

Pain, grief and suffering (reduced quality of life) caused by casualties

Pain, grief and suffering (reduced quality of life) caused by physical disabilities

Reduced functional capacity caused by injuries

Figure 1-7: (Cnt’d) – Share of each cost element of traffic injuries in Iran in 1390 (2011/2012)

Finally, by summing up the total cost through human capital method, the economic burden caused by road traffic fatalities in Iran in 1390 (2011/2012) has been estimated at more than 111 thousand billion IRR. It should be noted that this cost is only related to the health sector and does not include elements such as damage to vehicles, the time lost in accidents and administrative costs of insurance and the police. Therefore, with the calculations of the GDP equal to 5,100,000 billion IRR in 1390 (Chapter 5) the estimated cost in the health sector has been about 2.18% of the total GDP in that year. In addition, this figure has a value of equivalent to 75% of the total budget allocated to the health sector in 1390 (151,388, 924 million IRR). As a rough estimate and with regard to the previous experiences in Iran in the estimated cost of traffic accidents in which costs related to the health sector has been about 61% of the total cost of the accidents in the country (Ayati, 1387), the total cost of accidents is estimated over 196 thousand billion IRR, i.e. 3.85% of the GDP.

The above-mentioned amounts express the national and macro-level costs of the country. In addition to this macro estimation, there is need to calculate the cost endured by each victim of traffic crashes (injured or dead) which is calculable on the basis of macro costs. Estimation of individual costs is in need of the awareness of elements of effective cost on each category of the severity of the injuries. In other words, it should be specified what cost each death, disability or injury impose on the society. For this purpose, in Tables (2-7) up to (4-7) all the cases detailed in the process of calculation of the costs for the estimation of individual costs of death, disability and injury have been used.

Table (2-7) shows the elements of cost related to each death by using the human capital approach and willingness to pay. It is noted that the total cost figures, by using the WTP method, are a bit higher which is totally rational. Table (3-7) shows the cost caused by each physical disability and Table (4-7) shows the total medical costs and reduced functional capacity of the injured for any level of injury. In Figure (2-7), the scale of individual costs for each death has been shown by using the two methods of human capital and the willingness to pay.

In conclusion, it is necessary to present a summary description of the key results obtained from different analytical processes during this study. Table (5-7) shows the summary of the results achieved.

Table 2-7: Estimated cost of each traffic death in 1390 (Million IRR)

Elements of Cost Section Under Study Human Capital Method Willingness to Pay Method
Medical Table 2-6 79/568 79/568
Lost output Para 3-5 1136/05 0
Cost of pain, grief and suffering Para 1-1-6 472/7 0
Value of statistical life Para 2-6 0 1740
Total cost of each death ------ 1/688/318 1819/568

Table 3-7: Estimated cost caused by any disability in 1390 (Million IRR)

Elements of Cost Section Under Study Human Capital Method
Medical Table 4-6  
Lost output Para 3-5 307/13
Cost of pain, grief and suffering Para 1-1-6 513/35
Reduced functional capacity Para 3-6 14/19
Total cost of each disability  ------ 1063/206

Table 4-7: Estimated cost caused by traffic injuries at any severity level in 1390 (Million IRR)

Injury severity group Treatment costs of the injured (public payment) Treatment costs of the injured (private payment) Post-release costs Pre-hospital costs Reduced functional capacity Total
Non-hospital treatment 0.000 0.246 0.000 0.000 0.000 0.246
Outpatient injury 0.246 0.000 1.105 0.000 1.351
1 6/216 12/828 31/300 1/105 0/005 51/454
2 48/094 24/460 59/400 1/105 0/143 133/202
3 147/875 28/926 81/700 1/105 1/269 260/875
4 316/412 47/000 149/500 1/105 6/960 520/978
5 573/393 39/400 343/300 1/105 30/503 987/701
6 813/317 20/000 310/000 1/105 132/423 1276/845

Table 2-7: Comparison between individual costs for each death and disability (Million IRR)

Cost of each disability

Cost of each death on the basis of willingness for payment

Cost of each death on the basis of human capital

Reduced functional capacity

Value of statistical life

Cost of pain, grief and suffering

Lost output

Medical

Table 5-7: Summary of the results obtained in the estimated cost of traffic injuries in Iran in 1390 (2011/2012)

Main Categories Description of Result Amount
Medical Costs The share of the country’s emergency missions that have been related to traffic crashes 23%
Share of emergency traffic crashes missions in cities 72%
Credits related to current costs of emergency services and medical emergencies in 1390 Over 2400 Billion IRR
Share of traffic injuries in fixed costs of emergency stations About 732 Billion IRR
Total cost of traffic crash missions of Emergency 115 Over 185 Billion IRR
Share of traffic injuries in total costs of Emergency 115 Over 917 Billion IRR
Cost of firefighting, relief and rescue of the Red Crescent 55.5 Billion IRR
Share of private clients out of the total traffic injuries admissions 40%
Cost related to transfer of the injured by private vehicles 49.7 Billion IRR
Total costs spent on treatment of traffic injured within the framework of Article 92 3713.2 Billion IRR
Average cost of each night of hospitalization for different groups of traffic injuries 983 thousand IRR
Total number of outpatients injured in traffic throughout the country Over 337 thousand people
Treatment cost of outpatient victims of traffic crashes in the country About 82.9 Billion IRR
Hospital treatment costs paid by the victims of traffic crashes themselves About 12000 Billion IRR
Number of injured not transferred to hospital and received non-hospital treatment Over 157 thousand people
Total cost of non-hospital treatment of the injured not transferred to hospital About 38.6 Billion IRR
Number of traffic injured released from hospitals throughout the country Over 820 thousand people
Total post-release treatment costs Over 29000 Billion IRR
 
Lost Output Total number of those killed in traffic crashes 20089 people
Country’s GDP in 1390 (2011/2012) 5100 thousand Billion IRR
Per capita GDP in 1390 72.1 Million IRR
Average age of the dead in traffic crashes 35.7 years
Total number of years of lost life for all ages and all victims of traffic crashes  (YLL) 176,168 years
Average years of lost life related to each death caused by traffic crashes 8.77 years
Number of permanent physical disability in 1390 211 people
Total number of years of lost life for all ages and all injured suffering from a degree of disability due to traffic crashes (YLD) 143,411
Average years of lost life related to each disability caused by traffic crashes 3/62 years
Total number of years of lost life for all those killed and injured suffering from a degree of disability caused by traffic crashes (DALY) 319,579
Lost output caused by total traffic casualties 22822/181 Billion IRR
Lost output for each traffic death 1136/05 Million IRR
Lost output caused by all physical disabilities 12175 Billion IRR
Lost output related to each individual suffering from disability 307/13 Million IRR
Total value of the lost output caused by the casualties and disabilities due to traffic injuries 34997/172 Billion IRR
Indirect Costs Total medical costs for all deaths About 1500 Billion IRR
Cost of pain, grief and suffering for each death About 80 Million IRR
Cost of pain, grief and suffering for traffic casualties Over 9500 Billion IRR
Average cost of pain, grief and suffering for each death 472/7 Million IRR
Total medical costs for all injuries causing a degree of disability 9059/41 Billion IRR
Average medical cost of any injury causing a degree of disability 228/536 Million IRR
Total cost of pain, grief and suffering for all injuries causing a degree of disability Over 20000 Billion IRR
Cost of pain, grief and suffering for any injury causing a degree of disability 513/35 Million IRR
Extent of willingness to pay in 1390 for preventing death with 100% possibility 1740 Million IRR
Total value of lost life caused by traffic crashes by using willingness to pay method 34954/788 Billion IRR
Cost of reduced functional capacity for each person injured in traffic crashes 314,000 IRR
Cost of reduced  functional capacity for each person injured with severest traffic injuries Over 132 Million IRR
Total cost of reduced functional capacity caused by traffic injuries 261 Billion IRR
Total Costs Total cost of traffic injuries on the basis of human capital method (medical costs, lost output and reduced life quality) Over 111 thousand Billion IRR
Share of total costs in health sector from GNP 2/18%
Value equivalent to the traffic injuries cost in proportion to the total budget of the health sector in 1390 (2011/2012) 75%
Total cost of each death by using human capital method 1688/318 Billion IRR
Total cost of each death by using willingness to pay method 1819/568 Million IRR
Total cost caused by each physical disability 1063/206 Million IRR
Total costs of any injury at severest level of traffic injury (Group 6)   1276/845 Million IRR
Total costs of any injury at average level of traffic injury (average Groups 3 and 4) 390/93
Total costs of each light injury (Group 1) 51/454 Million IRR

In this study, the status quo of economic costs caused by road traffic injuries in Iran was reviewed. With regard to the study needs for better exploitation of the results and development of the application in coming years, the following cases are recommended as key requirements:

-         Conducting cost effectiveness study of road safety measures: by using the results of the estimated costs of road traffic injuries, it is emphatically recommended that studies be conducted on the cost effectiveness of road safety measures throughout the country and in relation to measures related to different executive organizations such as medical services and services related to health, institutions responsible for the construction and utilization of roads, monitoring activities and enforcement of police law and public training programs. It is recommended that this study be conducted within the framework of a statistical study “evaluating and monitoring” and/or economic analysis “cost-benefit”.

-         Comprehensive study of willingness to pay: Due to the very important role of the approach “willingness to pay” in the estimated cost of traffic injuries it is recommended that the process of using this method be implemented in a comprehensive study with the same topic and with an aim of estimating a valid amount of the value of the lost statistical life due to traffic injuries throughout the country. This approach has long been practically used in the developed countries and in recent years, hopeful steps have been taken in this regard in the developing countries as well. In the study conducted in the estimated costs of road traffic injuries in Iran the willingness to pay method was used experimentally and good results were achieved thereby, which encourages implementation of the comprehensive study in this regard in Iran.

-         Repetition of estimated costs of traffic injuries in the country: Due to the changes that take place every year either in the indices related to traffic injuries or economic indices, it is emphatically recommended that the process of cost estimation be repeated by using the latest available methods. For two reasons it is proposed that the process be used in a time-period of three years. First, the past experiences in Iran show that with the repetition of the project after three years (studies conducted by the Transportation Institute of the Road Ministry in 1384 and 1387) outstanding changes are observed in the methods and indices used. Second, the four-year period of the release of the report on world status of road safety by the World Health Organization can best cover the observed changes in the results of the estimated cost of traffic injuries.

The above-mentioned recommendations have expressed the most important study requirements and together with it, it is necessary to establish databases on crashes and traffic injuries by the related institutions. By conducting the above-mentioned studies it can be claimed that appropriate allocation of budgets and assets of government institutions in connection with the improvement of road safety and as a result, a relatively sustainable level of data analysis of traffic injuries in Iran can be obtained.

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