title: Injuries in special transportation services for elderly and disabled--a multi-methodology approach to estimate incidence and societal costs.
abstract: OBJECTIVE
  Previous research has shown that elderly and disabled travelers using Special Transportation Services (STS) are injured without being involved in a vehicle crash. In order to estimate the true costs for these vehicle-related injuries, the focus needs to be adjusted towards an incident/traveler-oriented perspective. The aim of the project was thus to utilize such a perspective, in order to make a best estimation of the true costs for injury incidents, related to STS in Sweden.
  
  
  METHODS
  In order to address the chosen perspective, a mixed-method approach was used, involving quantitative as well as qualitative research methods applied on four different sets of data, the hospital-based material (n=32), two sets of STS material (n=127), and interview-based material (n=1,000).
  
  
  RESULTS
  The results showed that the injury incidence rate in STS is considerable, i.e., 3.2 per 100,000 trips (ranging from 1.5-1.9 in STS taxis and 3.6-5.6 in STS special vehicles). However, this high incidence rate is not due to road traffic crashes, but to non-collision injury incidents involving elderly and frail passengers, easily sustaining injuries from minor to moderate external violence. Typically, this violence is affecting an older female STS user, while entering and exiting the vehicle. The true costs were estimated to be $35 million per annum or $2.6 per trip.
  
  
  CONCLUSIONS
  Future injury prevention measures should thus focus on safety in entering and exiting procedures.
authors.affiliation: The Umeå Accident Analysis Group, Emergency and Disaster Medical Center, University Hospital, Umeå, Sweden. perolof.bylund@vll.se
authors.forename: P-O
authors.initials: PO
authors.lastname: Bylund
authors.forename: A
authors.initials: A
authors.lastname: Wretstrand
authors.forename: T
authors.initials: T
authors.lastname: Falkmer
authors.forename: A
authors.initials: A
authors.lastname: Lövgren
authors.forename: J
authors.initials: J
authors.lastname: Petzäll
mesh_terms: D000368:Aged; D001336:Automobiles; D003365:Costs and Cost Analysis; D006233:Persons with Disabilities; D004869:Equipment Safety; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D013548:Sweden; D014186:Transportation / Q000295:instrumentation*; D014947:Wounds and Injuries / Q000191:economics*