BACKGROUND: There is no reliable estimate of costs incurred by motorcycle crashes. Our objective was to calculate the direct costs of all publicly funded medical care provided to individuals after motorcycle crashes compared with automobile crashes.
METHODS: We conducted a population-based, matched cohort study of adults in Ontario who presented to hospital because of a motorcycle or automobile crash from 2007 through 2013. For each case, we identified 1 control absent a motor vehicle crash during the study period. Direct costs for each case and control were estimated in 2013 Canadian dollars from the payer perspective using methodology that links health care use to individuals over time. We calculated costs attributable to motorcycle and automobile crashes within 2 years using a difference-in-differences approach.
RESULTS: We identified 26 831 patients injured in motorcycle crashes and 281 826 injured in automobile crashes. Mean costs attributable to motorcycle and automobile crashes were $5825 and $2995, respectively (p < 0.001). The rate of injury was triple for motorcycle crashes compared with automobile crashes (2194 injured annually/100 000 registered motorcycles v. 718 injured annually/100 000 registered automobiles; incidence rate ratio [IRR] 3.1, 95% confidence interval [CI] 2.8 to 3.3, p < 0.001). Severe injuries, defined as those with an Abbreviated Injury Scale ≥ 3, were 10 times greater (125 severe injuries annually/100 000 registered motorcycles v. 12 severe injuries annually/100 000 registered automobiles; IRR 10.4, 95% CI 8.3 to 13.1, p < 0.001).
INTERPRETATION: Considering both the attributable cost and higher rate of injury, we found that each registered motorcycle in Ontario costs the public health care system 6 times the amount of each registered automobile. Medical costs may provide an additional incentive to improve motorcycle safety.
Motor vehicle safety has improved substantially over the past 100 years.1 Between 2000 and 2010, for example, deaths related to motor vehicle crashes decreased by 55.1% in 19 developed countries.1 In contrast, deaths and injuries among a subset of those injured in motor vehicle crashes — motorcycle crashes — remained stable during the same time period.2
Although medical costs may provide incentive to improve motorcycle safety,3–5 there is no reliable estimate of medical costs incurred by motorcycle crashes. Previous calculations of medical costs attributable to motorcycle crashes are limited to reviews of hospital charges at single centres.6 Estimates derived from these reviews are incomplete, neglecting costs incurred after a patient’s discharge, for example.6–8
It is now possible to calculate patient-level medical costs in Ontario, Canada (population 13.6 million in 2014) with methodology that links publicly funded health care use to individuals over time.9 Using this methodology from the payer perspective, our objective was to calculate the direct costs of all publicly funded medical care provided to individuals who presented to hospital after motorcycle crashes compared with automobile crashes. We also examined the population incidence of injuries resulting from these crashes. Our hypothesis was that medical costs and injury rates attributable to motorcycle crashes, which can occur at high speeds and usually involve less personal protection, are significantly higher than those attributable to automobile crashes.