Differences in urban and rural accident characteristics and medical service utilization for traffic fatalities in less-motorized societies

Fatalities from traffic accidents in less-motorized societies are an important global issue. We aimed to characterize the geographic differences of fatalities in such societies to facilitate the development of targeted interventions. This study linked police reports, hospital data, and vital registration data from Taiwan with special reference to accident factors in pre-hospital deaths and medical care in hospital deaths. A higher percentage of pre-hospital deaths were observed following rural as compared to urban traffic accidents. The deaths due to rural accidents can be attributed to lower use of restraints (i.e., helmets or seat belts), lower percentage of motorcyclists, and more highway accidents. A higher percentage of victims in rural accidents were transported to distant medical centers rather than to local hospitals. Specific interventions, such as intelligent emergency medical systems, campaigns for helmets and seat belt usage, enforcement of helmets and seat belt use, and speed control measures should be targeted to rural areas. Cooperation between the vehicle industry and emergency medical providers in rural traffic accident rescue teams may decrease the numbers of deaths in these regions.