Skip to main content
Log in

Confidential enquiry into avoidable vehicle accident deaths in the province of Modena, Italy

  • Published:
European Journal of Epidemiology Aims and scope Submit manuscript

Abstract

The authors describe the methods and results of a kind of study – confidential enquiries into avoidable deaths – very rarely performed in the Mediterranean area. After assessing some quali/quantitative evaluation criteria, an independent expert panel investigated the quality of each step in emergency health care. Information was collected by clinical and forensic reports (clinical method). Of 102 cases, 4 were avoidable deaths and 18 probably avoidable. These results, which are comparable with other similar ones found in Italy (autoptic method) and abroad, have been useful in highlighting some health care errors: in particular, in on-site care and in emergency department diagnosis and treatment. Other avoidable factors emerging were the inappropriateness of transporting severe trauma cases to a small hospital lacking proper equipment and trained staff, and the importance of staff training in first emergency care of severe trauma on ambulance. This situation had been highlighted previously and led to implementation of trauma centres. The methods implemented turned out to be quite statistically reproducible and have been used in local health care planning, especially in the rearrangement of ambulance deployment and emergency staff training.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. WHO. World Health Statistics Annual 1990, Geneva 1991.

  2. Australian Institute of Health and Welfare, Australian Health 1994. The fourth biennial health report of the Australian institute of health and welfare. Canberra: Australian Government Publishing Service, 1994.

    Google Scholar 

  3. Rice DP, MacKenzie EJ, Jones AS. Cost of injury in the United States: A report to Congress. S. Francisco: Institute for Health and Ageing, University of California, 1989.

    Google Scholar 

  4. MMWR, Economic Impact of Motor-Vehicle Crashes-United States, 1990. MMWR 1993; 42: 443–448.

    Google Scholar 

  5. Borkestein RF, Crowther FG, Shumate RP, Zeil WB, Zylmana R. The role of the drinking driver in traffic accidents. Blutalkohol 1974; 11(suppl): 1–132.

    Google Scholar 

  6. McLean AJ, Holubowycz OT, Sandow BL. Alcohol and crashes: Identification of relevant factors in this association. Report N. CR11. Canberra: Office of Road Safety, Commonwealth Department of Transport, 1980.

    Google Scholar 

  7. Taggi F. Some considerations on epidemiology and the prevention of road accidents Workshop: Development and considerations for the study and organisation of the action taken regarding road safety in the province of Modena. Modena, 22 February 1995 (in Italian).

  8. Moore VM, Dolinis J, Woodward AJ. Vehicle speed and risk of a severe crash. Epidemiol 1995; 6: 258–262.

    Google Scholar 

  9. Fides BN, Runbold G, Leening A. Speed behaviour and drivers' attitudes to speeding. Report no. 16, Hawthorn, Victoria: Vic Roads, 1991.

    Google Scholar 

  10. Taggi F. Safety helmet law in Italy. Lancet 1988; 1: 182.

    Google Scholar 

  11. Ranzi A, Danielli G, Gaudio D, Lauriola P, et al. The prevention of road acidents in the planning of projects on traffic circulation: Comparison of methodologies used for the forecasting and simulation of scenarios in three Communes in the province of Modena. Province of Modena-ARPA, 1999 (in Italian).

  12. Stocchetti N, Pagliarini G, Gennari M, et al. Trauma care in Italy evidence of in-hospital preventable deaths. J Trauma 1994; 36: 401–405.

    PubMed  Google Scholar 

  13. Putignano C, Pennisi L. The cost of road accidents for society, 1998 (in Italian) in press.

  14. Tosatti F. Gravity and health costs of road accidents according to typology: First examples and proposals. Conference, Road accidents: Knowing how to avoid them, Modena 24–25, May 1996 (in Italian).

  15. Galavotti S, Goldoni CA, Lauriola P, Tosatti F. Road accidents in the province of Modena in the period 1983–90, Province of Modena, 1994 (in Italian).

  16. Holland WW (ed) European Community Atlas of Avoidable Death Oxford, Oxford University Press. Commission of the European Communities, 1988.

  17. Holland WW (ed) European Community Atlas of ‘Avoidable Death’ Vol I. Oxford, Oxford University Press. Commission of the European Communities, Health Services Research N. 6, 1990.

    Google Scholar 

  18. Rutstein DD, Beremberg W, Chalmers TC, Child CG, et al. Measuring the quality of medical care. N Eng J Med 1976; 294: 582–588.

    Google Scholar 

  19. Buck N, Devlin HB, Lunn JN. Report of the confidential enquiry into perioperative deaths. London, Nuffield Provincial Hospital Trust and the King's Fund for Hospitals, 1987.

    Google Scholar 

  20. Campling EA, Devlin HB, Lunn JN. The report on the national enquiry into perioperative deaths 1989, London, HMSO (Her Majesty's Stationery Office), 1990.

    Google Scholar 

  21. Campling EA, Devlin HB, Hoile RW, Lunn JN. The report on the national confidential enquiry into peri-operative deaths. National confidential enquiry into perioperative deaths. London HMSO (Her Majesty's Stationery Office), 1993.

    Google Scholar 

  22. Bouvier-Colle MH, Varnoux N, Bréart G. Maternal death and sub-standard care: The result of a confidential enquiry in France. Medical experts Committee. Eur J Obst Gynecol Reprod Biol 1995; 58: 3–7.

    Google Scholar 

  23. Turnbull A, Tindall VR, Beard RW, et al. Report on confidential enquiries into maternal death in England and Wales 1982–84. Department of Health Report of Health and Social Subjects 41, 1989.

  24. Wolkind S, Taylor EM, Waite AJ, Dalton, Emery JL. Recurrence of unexpected infant death. Acta Paediatr 1993; 82: 873–876.

    PubMed  Google Scholar 

  25. Payne JN, Milner PC, Saul C, Bowns IR, Hannay DR, Ramsay LE. Local confidential enquiry into avoidable factors in deaths from stroke and hypertensive disease. BMJ 1993; 307: 1027–1030.

    PubMed  Google Scholar 

  26. Cales RH, Trubkey DD. Preventable trauma death. A review of trauma care systems development. JAMA 1985; 254: 1059–1963.

    PubMed  Google Scholar 

  27. Baker SP, O'Neil B, Haddom W Jr, et al. The injury severity score: A method for describing patients with multiple injuries and evaluating emergency care. J Trauma 1974; 14: 187–196.

    PubMed  Google Scholar 

  28. US Congress, Office of Technolgy Assessment. Identifying health technologies that work: Searching for evidence, OTA-H-608, Washington, DC: US Government Printing Office, September 1994.

    Google Scholar 

  29. Fleiss JL. Statistical Methods for Rates and Proportions, Wiley 1981.

  30. Holman CDJ. Epidemiologic programs for computers and calculators: Analysis of interobserved variation on a programmable calculator. Am J Epidemiol 1984; 120: 154–161.

    PubMed  Google Scholar 

  31. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33: 159–174.

    PubMed  Google Scholar 

  32. Hill DA, West RH, Duflou J. Value of the prospective ‘before and after’ study as a methodology to evaluate outcome in a trauma centre. Aust NZJ Surg 1993; 63: 940–945.

    Google Scholar 

  33. Maio RF, Burney RE, Gregor MA, Baranski MG. A study of preventable trauma mortality in rural Michigan. J Trauma 1996; 41: 83–90.

    PubMed  Google Scholar 

  34. Sugrue M, Seger M, Sloane D, Compton J, Hillman K, Deane S. Trauma outcomes: A death analysis study. Ir J Med Sci 1996; 165: 99–104.

    PubMed  Google Scholar 

  35. Draaisma JM, De Haan AFJ, Goris RJA. Preventable trauma death in the Netherlands: Prospective multicenter study. J Trauma 1989; 29(11): 1552–1557.

    PubMed  Google Scholar 

  36. Eggold R. Trauma care regionalization: A necessity. J Trauma 1983; 23(3): 260–262.

    PubMed  Google Scholar 

  37. Lowe DK, Gately HL, Goss JR, et al. Patterns of deaths, complication, and error in the management of motor vehicle accident victims: Implication for a regional system of trauma care. J Trauma 1983; 23(6): 503–509.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lauriola, P., Tosatti, F., Schiavi, A. et al. Confidential enquiry into avoidable vehicle accident deaths in the province of Modena, Italy. Eur J Epidemiol 16, 67–74 (2000). https://doi.org/10.1023/A:1007687120935

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1007687120935

Navigation