2024-08-12-世界银行-约旦道路交通伤害的负担_政策证据（英）_110页_3mb

Burden of Road Traffic Injuries in Jordan: Evidence for Policy

Abstract and Background

The study examines the significant burden of road traffic injuries (RTIs) in Jordan, a growing public health and economic issue. With 169,409 crashes in 2022, resulting in 562 deaths and extensive injuries, RTIs lead to death among children and young adults and are the second-leading cause of death for those aged 20–64. Most crashes occur on main roads during early mornings or nights, involving cars and motorcycles, with males comprising 79% of patients. The research, funded by the Global Road Safety Facility, used a mixed-methods approach, including hospital-based surveillance, follow-up surveys, and key informant interviews across six hospitals. RTIs cause substantial disability and financial costs, with severe implications for healthcare systems and society.

Methodology

The study employed a mixed-methods design, combining quantitative data collection from hospital surveillance and patient follow-up surveys (at one and three months post-injury) with qualitative insights from key informant interviews. It involved 47 patients recruited from six hospitals across Jordan, focusing on demographics, crash characteristics, medical care, and disability outcomes. However, low patient recruitment limited the sample size. Data were analyzed to assess factors influencing disabilities and costs, yielding key findings.

Key Findings

• Demographics and Crashes: Patients were predominantly male (79%) and in their 30s. Crashes occurred mainly on main roads during night or early morning hours, with 72% of vehicles being cars and 40% motorcycles/bicycles. Seatbelt and helmet use was low.
• Injuries and Treatment: 58% had single injuries, mostly to extremities. Treatments included sutures, surgeries, and internal fixation for fractures. 74% received prehospital care, primarily from ambulance staff.
• Costs and Disability: Immediate hospital costs were reported by 49%, with physical therapy and medications as major follow-up expenses. At one month, 79% experienced disability (mild to extreme), but 73% were disability-free by three months.
• Challenges: Data collection faced barriers, including low admission rates due to financial constraints, medico-legal concerns, and reporting gaps in healthcare settings.

Recommendations and Policy Implications

• Enhance Data Systems: Implement an RTI registry in hospitals for better surveillance and standardized reporting to inform evidence-based policies.
• Improve Preventive Measures: Strengthen enforcement of traffic laws, promote safer behaviors (e.g., seatbelt use), and invest in road infrastructure improvements to reduce accidents.
• Financial Support: Reform insurance mechanisms to enable cashless payments for RTI cases, reduce out-of-pocket expenses, and facilitate quicker access to care.
• Strengthen Emergency Response: Expand early intervention protocols, such as prehospital care training and emergency medical services, and adopt the Safe System approach for road safety.
• Capacity Building: Train healthcare and traffic stakeholders on RTI management and integrate community awareness campaigns focusing on high-risk groups.

Conclusion

Road traffic injuries impose a heavy disability and economic burden in Jordan, particularly affecting working-age populations. Without targeted interventions, including behavior change, improved data, and enhanced healthcare access, the impact will persist. This study underscores the need for a coordinated, multisectoral strategy to mitigate RTIs and support recovery.