Evaluation of the Oregon DMV Medically At-Risk Driver Program

G. Strathman, James; Bronfman, Lois Martin; Dong, Hongwei · 2009 · ROSA P / Oregon. Dept. of Transportation. Research Unit

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Summary

This report evaluates the Oregon Driver and Motor Vehicle (DMV) Services Medically At-Risk Driver Program, which mandates physician reporting of patients with severe, uncontrollable cognitive or functional impairments. Implemented in 2003, the program expanded upon previous regulations to cover a broader range of conditions. The study aimed to assess the safety risk of drivers suspended under this mandatory reporting scheme and to identify operational issues through stakeholder feedback. The research was motivated by concerns regarding the effectiveness of mandatory reporting, physician compliance, and the balance between public safety and driver mobility. The methodology combined quantitative safety analysis with qualitative stakeholder interviews. Researchers analyzed crash and traffic conviction records for drivers suspended under the mandatory reporting program, comparing them to those in the voluntary reporting program and a representative sample of the general Oregon driving population. The analysis covered periods before and after license suspension, utilizing multivariate models to account for age and exposure differences. Additionally, structured interviews were conducted with DMV staff, medical consultants, primary care providers, driving assessment specialists, and community contacts to evaluate program performance, training, and data systems. Key findings indicated that drivers in the mandatory program were significantly older than the general population, with a median age difference exceeding 30 years. Prior to suspension, this group exhibited a crash incidence approximately 40% of the general population, though major conviction rates were 200% higher. Among drivers aged 76 and older, crash and conviction rates were somewhat higher than their age-matched peers. Post-suspension, despite 87% of subjects remaining suspended, crash and conviction incidences increased, particularly among the oldest cohort. Drivers who regained privileges showed the highest post-suspension crash and conviction rates, suggesting potential gaps in the licensing examination process. Notably, prior crash history was a significant predictor of post-suspension crashes. Stakeholder interviews revealed widespread perceptions of under-reporting, particularly for dementia, and highlighted barriers such as lack of insurance coverage for driving assessment and rehabilitation services. The study concludes that while the mandatory program targets high-risk individuals, the safety threshold for intervention is lower than in other problem-driver programs, and many suspended drivers mitigate risk by reducing exposure. However, the upward trend in safety risk and the high incidence of violations among reinstated drivers suggest that current licensing exams may not adequately assess impairment-specific driving fitness. The authors recommend enhanced outreach to improve physician reporting compliance, integration of mandatory and voluntary reporting databases, and consideration of tailored examination protocols similar to those used in Wisconsin. Furthermore, expanding insurance coverage for driving assessment services is urged to support safe mobility for impaired drivers.

Key finding

Drivers who regained driving privileges after suspension exhibited crash and conviction rates 310% and 250% of the general population respectively, while those who remained suspended accounted for only 54.5% of crashes and 62% of convictions despite comprising 87% of the subject group.

Methodology

naturalistic

Provenance

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Summary generated by qwen3.6-27b-prismaquant on 2026-06-10; verification: verified.

Topics

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• licensing policy
• medical conditions
• cognitive impairment
• fitness to drive assessment
• mci dementia driving
• older driver retraining

Information type

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• Applied Guidance: countermeasure evaluation
• Theoretical Contribution: computational model