Graduation Date

Summer 8-14-2015

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Programs

Health Services Research, Administration, and Policy

First Advisor

Fernando A. Wilson

Abstract

Background Traffic safety has placed a tremendous economic and social burden on individuals and nations. Gasoline prices have been linked to traffic safety in the recent studies. Higher gasoline price may prompt people to reduce expenses by changing travel distance and frequency, transportation mode, or driving behaviors.

Objective This study aims to examine the relationship of gasoline prices to hospital utilization and cost for motorcycle and non-motorcycle motor vehicle injuries in the United States.

Methods Data on inpatient hospitalization for motor vehicle injuries were obtained from the 2001-2010 Nationwide Inpatient Sample, which is part of the Healthcare Costs and Utilization Project. Gasoline price data were gathered by the Federal Highway Administration. Panel feasible generalized least squares models were used to estimate the effects of inflation-adjusted gasoline prices on hospitalization rate (per 10 million population). Additionally, a conceptual system dynamic model was developed to examine the traffic safety system response to rising gasoline price, and it was used to estimate the effects of gasoline tax and transport policies on reducing motor vehicle injuries.

Results It was predicted that a $1.00 increase in the gasoline tax was associated with reducing the number of hospitalizations for non-motorcycle MVC injuries by 8,347, and lowered hospital costs by $143 million in 2014. However, the $1.00 increase in the gasoline tax was associated with increasing the number of hospitalizations for motorcycle crash injuries by 3,574, and increased hospital costs by $73 million. Also, our experiments of system dynamics modeling found that increasing passenger-miles traveled would be effective in reducing motor vehicle injuries in the long run.

Conclusion Our findings suggest that the increased hospital utilization and costs from motorcycle crash injuries after a rise in the price of gasoline partially offset reductions in non-motorcycle MVC injuries. Therefore, gasoline tax could be a policy alternative to improve traffic safety, provided that it is paired with efforts to improve motorcycle safety. The development of public transportation system could also become an attractively alternative commuting mode to reduce motor vehicle injuries.

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