Estimation of the Economic Impact of Road Traffic Injuries in Belize. Final Report

Abstract

[Executive Summary]. Background: Road traffic injuries (RTI) have an important negative impact at all levels. RTI cause a high number of sick leave days and produce an elevated amount of healthy life years lost. All this has serious consequences on Belizean society as a whole. With the high rate of road traffic injuries in Belize, there is a need to document the economic burden of RTI in the country. Such information will be of great value, as it will facilitate local planning and programming for injury prevention and the promotion of road safety. Objective: To estimate the economic cost of road traffic injuries in Belize. Methods: A cross-sectional study that estimated the cost of road traffic injuries in Belize during 2007 was conducted using secondary cost data and assuming the health system and social perspectives. Two major databases were analyzed: the mortality database, containing all deaths during 2001-2007, and the national hospital discharge database, containing all discharges during 2007. Additionally, a third database containing all emergency ambulance services provided by BERT to persons involved in RTI in the Belize District during 2007 was analyzed. A descriptive analysis was performed for all databases. Central tendency and dispersion measures were calculated for the continuous variable (mean, median, standard deviation, maximum and minimum value) as well as frequencies and percentages for the categorical variables. Years of Potential Life Lost (YPLL) were estimated using the life expectancy of Belize for 2008 reported by PAHO (76.1). The difference between age at death and life expectancy was calculated for each injured, subsequently the total number of YPLL was estimated summing all individual YPLL. Indirect cost associated with premature death was estimated using the human capital approach, taking two different salaries as reference: the minimum wage for 2007 and the Belizean average income of 2007. Costing was done in 2007 Belize Dollars after adjusting by inflation using the Belize National Consumer Price Index. Costs accrued after one year or more were also discounted at an annual rate of 3% and 5%. Total estimation of RTI economic costs used a decision tree model approach. Multi-way sensitivity analysis was carried out in order to incorporate uncertainty in the estimations. Results: A total of 63 (or 61 if adjusted) people died as a consequence of RTI during 2007 (a mortality rate of 20.72 deaths per 100,000 inhabitants), 338 were hospitalized and a total of 565 slightly injured was estimated. A total of 2,501 Years of Potential Life were Lost in Belize due to premature death. All this translated in a total economic cost of BZ$31,966,045 due to RTI during 2007. This figure represents 1.26% of Belizean GDP during 2007. The great majority of the cost is for fatal injuries, specifically on indirect cost attributed to premature death. Direct cost was estimated at BZ$491,549, of which 2.09% was spent on fatalities, 61.61% on severely injured and 36.30% on slightly injured. Conclusions: These results make evident the great problem that RTI cause to the health system in Belize and to the society as a whole. The economic cost estimations make clear the need to prevent RTI utilizing a strategic and multisectoral approach that focuses on addressing the main problems identified.