Remoteness and regional influences on road crash injury outcomes in Western Australia, 1995-2010

The State of Western Australia covers over 2.5 million square kilometres and the majority of this land area is sparsely populated. Remoteness and accessibility issues have implications not only for planning road safety initiatives, but for the outcomes of road crashes that occur in these locations. It has already been shown that in Western Australia, a disproportionate number of trauma deaths occur in rural areas, with transport injuries being the leading cause (Fatovich and Jacobs, 2009). This project uses linked road crash, hospital admission, death, insurance and trauma registry data for the years 1995-2010. The severity of crash casualties’ injuries are determined using the Abbreviated Injury Severity (AIS) Scores assigned by the RPH trauma registry, and the International Classification of Diseases based Injury Severity Score (ICISS) calculated using linked hospital and death data. The exact locations of the crash sites are used to assign each crash various remoteness measures (including ARIA+) and also to calculate travel distances from the crash site to the hospital visited (using geographical information systems). A number of regional-level influences (e.g. average road curvature and junction density for the area) are assigned to crashes according to location. Multivariate regression models determine whether these measures of remoteness and regional influences are risk factors for serious injury and/or death, after controlling for individual-level demographic and behavioural variables, and crash-level variables.