The cost of not wearing seat belts. A comparison of outcome in 3396 patients.

Data from the North Carolina Trauma Registry were analyzed to determine the effect of seat belt usage on outcome in motor vehicle accidents. Of 6237 persons involved in motor vehicle accidents, data on seat belt usage were available for 3396. Of these, 1916 were not and 1480 were wearing seat belts. The mean hospital charge in belted patients was $10,500 +/- $18,200; and in unbelted patients, $15,250 +/- $26,300 (p < 0.001). The total hospital charges were $23 million for the 1508 patients not wearing seat belts. If the unbelted patients had outcomes similar to belted patients, the charges resulting from caring for the 1508 patients would have been $15.8 million, a potential savings of $7.2 million. There were 135 deaths among the unbelted patients (7.0%) and 47 deaths among the belted patients (3.2%) (p < 0.001). A similar projection of belted outcome for unbelted patients suggests that seat belt usage could have reduced the unbelted mortality rate by over one half. Patients wearing seat belts also had significantly shorter hospital stays, fewer days in the intensive care unit, and fewer days on the ventilator (p < 0.001). Seat belt usage is associated with a significant decrease in mortality rate, hospital charges, length of stay, intensive care unit stay, and ventilator requirements. Seat belts could have saved at least 74 lives and 7.2 million dollars during the period from October 1, 1987 to July 1, 1989 in patients seen in the seven trauma centers in North Carolina.