title: Motor vehicle injury, mortality, and hospital charges by strength of graduated driver licensing laws in 36 States.
abstract: BACKGROUND
  To assess the relation between strength of graduated driver licensing (GDL) laws and motor vehicle (MV) injury burden, this study examined injury mortality, hospitalizations and related charges for 15 year to 17 year olds in 36 states by strength of GDL legislation.
  
  
  METHODS
  Data sources include the CDC's Web-Based Injury Statistics Query and Reporting System (WISQARS) and the 2003 Healthcare Cost and Utilization Kids' Inpatient database (KID). Hospital admissions for injuries in 15 year to 17 year olds (n = 49,520) are unweighted. Injury severity was assessed using ICDMAP-90 and International Classification of Injury Severity Scores. The Insurance Institute for Highway Safety rating system was used to categorize legislative strength: good, fair, marginal/poor, and none. Logistic regression was used to assess independent predictors of MV injury.
  
  
  RESULTS
  MV injury accounted for 14.6% of all-cause injury-related hospital admissions with 47.7% classified as drivers. Total MV occupant mortality was 14.6% lower after enactment of GDL with greater improvement observed in the good law category (26.0%). In multivariate models for hospitalized injury, all GDL law categories were protective for MV driver injury in 16 year olds. Compared with whites, black and Hispanic teens were more frequently injured as passengers than drivers. The contribution of MV occupant to all-cause injury-related hospital charges was 16.0% lower in good versus no-GDL categories and 39.5% lower for MV drivers.
  
  
  CONCLUSIONS
  These findings suggest that the presence of any GDL legislation is associated with a lower burden of MV-related injury and expenditures with the largest differences observed for 16-year-old drivers.
authors: Departments of Epidemiology, Injury Free Coalition for Kids, Mailman School of Public Health, Columbia University, New York, New York 10032, USA. jp376@columbia.edu
authors: Joyce C
authors: JC
authors: Pressley
authors: Camilla B
authors: CB
authors: Benedicto
authors: Lisa
authors: L
authors: Trieu
authors: Tiffany
authors: T
authors: Kendig
authors: Barbara
authors: B
authors: Barlow
mesh_terms: D000063:Accidents, Traffic / Q000191:economics* / Q000401:mortality* / Q000517:prevention & control; D000293:Adolescent; D000294:Adolescent Behavior; D017677:Age Distribution; D001333:Automobile Driver Examination / Q000331:legislation & jurisprudence*; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D012621:Seasons; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000191:economics / Q000401:mortality