Health Care Resources and 24,910 Deaths Due to Traffic Accidents: An Ecological Mortality Study in Poland

Agnieszka Genowska, Jacek Jamiołkowski, Krystyna Szafraniec, Justyna Fryc and Andrzej Pająk
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Agnieszka Genowska: Department of Public Health, Medical University of Bialystok, 15-295 Bialystok, Poland
Jacek Jamiołkowski: Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, 15-269 Bialystok, Poland
Krystyna Szafraniec: Department of Epidemiology and Population Studies, Jagiellonian University Medical College, 31-066 Krakow, Poland
Justyna Fryc: Faculty of Medicine, Medical University of Bialystok, 15-540 Bialystok, Poland
Andrzej Pająk: Department of Epidemiology and Population Studies, Jagiellonian University Medical College, 31-066 Krakow, Poland

IJERPH, 2021, vol. 18, issue 11, 1-14

Abstract: Background: Deaths due to traffic accidents are preventable and the access to health care is an important determinant of traffic accident case fatality. This study aimed to assess the relation between mortality due to traffic accidents and health care resources (HCR), at the population level, in 66 sub-regions of Poland. Methods: An area-based HCR index was delivered from the rates of physicians, nurses, and hospital beds. Associations between mortality from traffic accidents and the HCR index were tested using multivariate Poisson regression models. Results: In the sub-regions studied, the average mortality from traffic accidents was 11.7 in 2010 and 9.3/100.000 in 2015. After adjusting for sex, age and over time trends in mortality, out-of-hospital deaths were more frequently compared to hospitalized fatal cases (incidence rate ratio (IRR) = 1.68, 95% CI 1.45–1.93). Compared to sub-regions with high HCR, mortality from traffic accidents was higher in sub-regions with low and moderate HCR (IRR = 1.25, 95% CI 1.11–1.42 and IRR = 1.19, 95% CI 1.02–1.38, respectively), which reflected the differences in out-of-hospital mortality most pronounced in car accidents. Conclusions: Poor HCR is an important factor that explains the territorial differentiation of mortality due to traffic accidents in Poland. The high percentage of out-of-hospital deaths indicates the importance of preventive measures and the need for improvement in access to health care to reduce mortality due to traffic accidents.

Keywords: traffic accidents; health inequalities; out-of-hospital deaths; hospitalized fatal cases; health care disparities (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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