Extent and determinants of cost of road traffic injuries in an Indian city.
Studies aimed at estimating losses that are incurred as a result of road traffic injuries (RTIs), especially at the family level, are very limited. To ascertain the direct and productivity costs of road traffic injuries and their determinants. This study was a cross-sectional survey of all the road traffic crashes recorded by traffic police during 2004 in Chandigarh, a modern planned city of north India. All road traffic crashes recorded by the traffic police during the year 1st January to 31st December 2004 were included in the study. The houses of all the victims were visited. The direct costs included the immediate medical costs (i.e., emergency and hospital care, follow-up care, medicines and appliances, doctor bills, etc.), and nonmedical costs (transportation, property damage cost, etc.). Work productivity and activity questionnaire (WPAI-SHP), the health and labor questionnaire (HLQ) and Human Capital Method were used for estimating the productivity costs. Percentage, mean, standard deviation of the outcome parameters were calculated. Of the 121 crash victims listed, 95 agreed to participate in the study. The net direct costs incurred were Rs. 8,55,644 ($19,991). The vehicle repair costs constituted more than half of such cost. Surgery, which was conducted in 28 cases, constituted 14.5% of the direct costs. The total productivity cost incurred was Rs. 8,06,24,530 ($1,883,750). Costs incurred due to premature mortality constituted over 99% of these productivity losses suffered by society. Lost wages due to the crash constituted less than 1% [Rs. 1,40,230 ($3276)] of the total productivity loss. Road traffic injuries are a significant financial drag on the society. The productivity costs far outweigh the direct costs. Premature mortality, vehicle damage and medical costs constituted the major share of the cost of RTIs.