Estimating the value of statistical life and evaluating quality of life outcomes among motorcycle crash survivors at selected public health providers

Abstract

Road Traffic Injuries (RTIs) remain a pressing public health concern, particularly in assessing survivors' Quality of Life (QoL) and economic valuations. This cross- sectional study estimated the Value of Statistical Life (VOSL) through Willingness to Pay (WTP) per year for reductions in fatality and injury risk, national road safety programs, and medical treatment (initial and follow-up) among motorcycle crash survivors. It also evaluated QoL one month post-discharge. Data were collected between August 2022 and September 2023 at the emergency departments of Hospital Sultanah Bahiyah (Alor Setar) and Hospital Sungai Buloh (Selangor). The Contingent Valuation Method (CVM) estimated VOSL from WTP, while the Revised Trauma Quality of Life (RT-QoL) instrument assessed QoL. Descriptive statistics, Generalized Linear Models (GLM) with Gamma distribution, and Binary Logistic Regression (BLR) were used. Of 546 respondents, 81% were pillion riders and 364 were male. Mean WTP per year was RM28 for fatality risk reduction, RM53 for injury risk, RM36 for safety programs, RM64 for emergency eare, and RM59 for follow-up treatment, estimating fatality costs at RM94,058 - RM101,294 and injury at RM24,495 - RM28,850. WTP for national safety programs was valued at RM725,333 - RM768,000. WTP for fatality risk reduction was influenced by education, income, insurance, and travel purpose; injury risk WTP by age, education, occupation, insurance, travel purpose, and crash history; and WTP for safety programs by similar factors as injury risk. Emergency treatment WTP was higher among younger individuals, those with higher education, mid-skilled workers, and lower among B40 groups, reflecting healthcare access disparities. Follow-up WTP was shaped by occupation, income, injury type, insurance, license status, and travel purpose. QoL outcomes were predicted by education, ethnicity, and occupation across emotional, functional, and physical domains. Emotional QoL was reduced by low income, lack of license or insurance, and fractures, with fractures associated with 38.3% lower odds of high emotional well-being. Functional QoL was linked to injury severity (MAIS), license status, pillion riding, insurance, and crash history. Physical QoL was associated with income, household size, insurance, travel purpose, and rider type, with pillion riders reporting better outcomes. Overall, the study emphasizes the role of socio-demographic and pre-crash factors in shaping both WTP and QoL, highlighting the need for targeted policies, equitable healthcare, and educational interventions for vulnerable road users.