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Role of State Driver Licensing Policies and Physician Reporting Laws on Older Driver Safety

Agimi, Yll (2012) Role of State Driver Licensing Policies and Physician Reporting Laws on Older Driver Safety. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

This study aimed to determine the effect of state licensing and physician reporting requirements on older driver safety, guided by hypotheses that states with stricter requirements would result in lower fatal crash rates, lower older driver crash hospitalization rates and a lower prevalence of dementia among those hospitalized compared to states with fewer requirements. Three separate studies were performed. The first study used 2004 to 2009 fatal crashes to examine the effect of state requirements on fatal crash incidence rates using Generalized Estimating Equation (GEE) negative binomial regression models. The second study compared 2004 to 2009 crash-related hospitalizations according to state licensing requirements; with hospitalization incidence rates estimated using three GEE negative binomial regression models. The third study examined crash-related hospitalized drivers to estimate the effect of state requirements on the prevalence of dementia using logistic regression models. Vision testing at in person renewals showed consistent association with lower fatal crash rates, lower hospitalization rates and a lower prevalence of dementia among those hospitalized. Vision testing was especially predictive of a lower crash fatality rate among drivers ages 80 to 84 and lower dementia prevalence among hospitalized drivers ages 60 to 69, reaffirming the safety benefits of vision testing. Physician reporting requirements, mandated or legally protected, and length of licensing renewal lacked any independent association with fatal crash rates, crash-hospitalization rates or dementia prevalence.
The public health significance of this research is its finding that more restrictions on driving do not translate in lower crash rates among older drivers. This research informs older drivers, their families, physicians and state agencies on licensing and reporting requirements that provide safety benefits to assist their safety and mobility decisions. It also informs stakeholders on the utility of screening older patient drivers and demonstrates the need for improved physician tools for the assessment of older adult driving safety.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Agimi, Yllyll.agimi@gmail.com
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairAlbert, Steven / M.smalbert@pitt.eduSMALBERT
Committee MemberSonger, Thomas / J.tjs@pitt.eduTJS
Committee MemberYouk, Ada / O.ayouk@pitt.eduAYOUK
Committee MemberDocumet, Patricia / I.pdocumet@pitt.eduPDOCUMET
Date: 2 July 2012
Date Type: Completion
Defense Date: 5 March 2012
Approval Date: 2 July 2012
Submission Date: 9 April 2012
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Number of Pages: 146
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Behavioral and Community Health Sciences
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: physician reporting, older driver safety, vehicle-related crash hospitalizations, fatal crashes, dementia, negative binomial modeling
Date Deposited: 02 Jul 2012 14:04
Last Modified: 02 Jul 2017 05:15
URI: http://d-scholarship.pitt.edu/id/eprint/12018

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