Measuring road traffic safety performance: Monitoring trends in nonfatal injury.

Traditional indicators used to monitor trends in nonfatal injury are influenced by a range of factors other than the incidence of injury. Indicators based on threat-to-life scales offer a means of addressing this problem. The aim of the research described in this article was to compare trends in the official indicators with trends in selected threat-to-life indicators. We compared indicators based on the New Injury Severity Score and the International Classification of Diseases-based Injury Severity Score with the official New Zealand indicators; namely, (1) reported injuries, (2) reported injuries per 10,000 vehicles, (3) reported injuries per 100,000 people, and (4) number hospitalized (discharges). All the official indicators suggest that there has been a substantive decline in nonfatal Motor Vehicle Traffic Crashes (MVTCs) for the period 1988-2000, but a notable increase in 2001. The latter appear to be artifactual increases due to changes in patterns of data collection and do not reflect any real changes in incidence. Further support for this is provided by the results for the two threat-to-life indicators, which suggest that the decline observed for 1988-98 may have been attributable to a decline in the ascertainment or occurrence of minor injuries since those injuries, which represent a significant threat to life, have not declined to the same degree. Given the prominence of motor vehicle crashes as a cause of unnecessary morbidity, more thought needs to be given to deriving valid indicators for measuring trends in serious nonfatal injury.