Burden of hospitalizations for bicycling injuries by motor vehicle involvement: United States, 2002 to 2009

Abstract

Background: Bicycling and bicycling injuries have increased during the past decade in the United States, but research on the extent and outcomes of injuries has lagged behind. This study aimed to estimate the current burden of injury from bicycling injury hospitalizations by motor vehicle crash (MVC) and non-MVC in the United States.

Methods: We included patients with primary or secondary diagnosis e-codes corresponding to MVC or non-MVC bicycle injury, drawn from the US Nationwide Inpatient Sample (2002-2009). Descriptive statistics, linear regression, and logistic regression were used to examine patient and hospital characteristics (length of stay, total charges, nonroutine discharges, and demographics) associated with hospitalizations for bicycling injuries by motor vehicle involvement.

Results: On average, from 2002 to 2009, there were an annually estimated 6,877 MVC and 18,457 non-MVC bicycle injury hospitalizations nationwide. This translates to more than $1 billion of hospital charges overall, $425 million for MVC and $588 million for non-MVC per year. After controlling for covariates, MVC bicycling injury hospitalizations had an average length of stay that was 2 days longer (95% confidence interval [CI], 1.8-2.3) and an average hospitalization charge of $23,424 more (95% CI, $21,360-$25,538) than non-MVC. Those with MVC bicycling injuries were more than two times as likely to have a nonroutine hospital discharge than non-MVC (odds ratio, 2.22; 95% CI, 2.06-2.39).

Conclusion: The burden of injury from bicycle crashes is large overall, and MVC-related bicycling injuries result in longer hospital stays, higher costs, and more nonroutine hospital discharges than non-MVC, despite the fact that non-MVC hospitalizations are more frequent and result in higher total charges, overall. To have the greatest impact on reducing the burden of injury from bicycle crashes, educational interventions, policy, and infrastructure changes should include all age groups and prioritize reducing bicycle-motor vehicle collisions.

Level of evidence: Epidemiologic study, level III.