Abstract
The Utah Driver License Division has implemented a program since 1979 that restricts drivers with medical conditions by functional ability category (medical condition) by assigning them a functional ability level. This study compares the citation, all crash, and at-fault crash rates (per eligible licensed days) of medical conditions drivers at each functional ability level, by category, to the rates of comparison drivers matched on age group, gender and county of residence over a five year period. Analyses were performed separately for drivers reporting single medical conditions and those reporting 2 or more medical conditions. Probabilistic linkage was used to link data from different databases in order to determine the crash, at fault crash and citation rates by functional ability level classification at the time of occurrence. Corresponding relative risks and confidence intervals were calculated. Overall, for most functional ability categories, drivers in the medical conditions program had higher crash and at-fault crash rates compared to their corresponding comparison groups, occurring at the numerically lowest (least restricted) functional ability levels. The relative risk (odds ratios) was generally fairly modest, in the 1.5-2.5 range. For drivers with multiple medical conditions, the functional ability levels were collapsed into two groups, unrestricted and restricted driving privileges. Of the combinations of medical conditions analyzed, roughly half had higher risk of crashes and at fault-crashes than comparison drivers; unrestricted and restricted drivers did not appear to differ materially. Further evaluation of the medical conditions program, taking into account true exposure rates (miles driven), may be warranted.
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