BACKGROUND:Road traffic injuries (RTIs) have been one of the most critical public health problems in Thailand for decades. The objective of this study was to examine to what extent provincial economy was associated with RTIs, road traffic deaths and case fatality rate in Thailand. METHODS:A secondary data analysis on time-series data was applied. The unit of analysis was a panel of 77 provinces during 2012-2016. Data were obtained from relevant public authorities, including the Ministry of Public Health. Descriptive statistics and econometric models, using negative binomial (NB) regression, negative binomial regression with random-effects (RE) model, and spatial Durbin model (SDM) were employed. The main predictor variable was gross domestic product (GDP) per capita and the outcome variables were incidence proportion of RTIs, traffic deaths and case fatality rate. The analysis was adjusted for key covariates. RESULTS:The incidence proportion of RTIs rose from 449.0 to 524.9 cases per 100,000 population from 2012 till 2016, whereas the incidence of traffic fatalities fluctuated between 29.7 and 33.2 deaths per 100,000 population. Case fatality rate steadily stood at 0.06-0.07 deaths per victim. RTIs and traffic deaths appeared to be positively correlated with provincial economy in the NB regression and the RE model. In the SDM, a log-Baht increase in GDP per capita (equivalent to a growth of GDP per capita by about 2.7 times) enlarged the incidence proportion of injuries and deaths by about a quarter (23.8-30.7%) with statistical significance. No statistical significance was found in case fatality rate by the SDM. The SDM also presented the best model fitness relative to other models. CONCLUSION:The incidence proportion of traffic injuries and deaths appeared to rise alongside provincial prosperity. This means that RTIs-preventive measures should be more intensified in economically well-off areas. Furthermore, entrepreneurs and business sectors that gain economic benefit in a particular province should share responsibility in RTIs prevention in the area where their businesses are running. Further studies that explore others determinants of road safety, such as patterns of vehicles used, attitudes and knowledge of motorists, investment in safety measures, and compliance with traffic laws, are recommended.

译文

背景:道路交通伤害(RTI)一直是泰国几十年来最严重的公共卫生问题之一。这项研究的目的是研究泰国的省级经济在多大程度上与RTI,道路交通事故死亡和病死率相关。
方法:对时间序列数据进行二次数据分析。分析单位是2012-2016年期间由77个省组成的小组。数据来自包括公共卫生部在内的相关公共部门。采用负二项式(NB)回归,带随机效应的负二项式回归(RE)模型和空间Durbin模型(SDM)进行描述性统计和计量经济学模型。主要的预测变量是人均国内生产总值(GDP),结果变量是RTI发生率,交通死亡和病死率。针对关键协变量对分析进行了调整。
结果:从2012年到2016年,RTIs的发病率从449.0例增加到524.9例/每100,000人口,而交通死亡的发生率在每100,000例死亡的29.7至33.2例之间波动。病死率稳步上升为每位受害者死亡0.06-0.07。在NB回归和RE模型中,RTIs和交通事故死亡与省级经济似乎呈正相关。在SDM中,人均GDP的对数铢增长(相当于人均GDP增长约2.7倍)使受伤和死亡的发生率增加了约四分之一(23.8-30.7%),具有统计意义。 SDM的病死率未发现统计学意义。 SDM还提供了相对于其他模型的最佳模型适用性。
结论:交通伤害和死亡的发生比例随着省的繁荣而上升。这意味着在经济上较富裕的地区应进一步加强预防RTIs的措施。此外,在特定省份中获得经济利益的企业家和商业部门应在其经营所在的地区共同承担预防RTI的责任。建议进行进一步研究,以探索其他影响道路安全的因素,例如所用车辆的模式,驾驶者的态度和知识,对安全措施的投资以及是否遵守交通法规。

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