Research notes : evaluation of the oregon medically at-risk driver program.

NHTSA · 2009 · ROSA P / Oregon. Dept. of Transportation. Research Unit

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Summary

This research note evaluates the effectiveness of Oregon’s Medically At-Risk Driver Program, which mandates physician reporting of drivers with functional or cognitive impairments. The study, conducted by Dr. James Strathman of Portland State University, aimed to assess the safety risks associated with drivers suspended under this program and identify potential improvements. Oregon’s program is notable for covering a broader range of conditions than similar mandatory reporting programs in other states. The evaluation focused on driver records from July 1, 2004, to December 31, 2005, analyzing 1,556 individuals suspended under mandatory requirements and 910 voluntarily referred individuals. The methodology involved comparing crash and conviction rates during the 18-month periods prior to and following license suspension against a sample of the general Oregon driving population. The analysis calculated relative safety risks by dividing the incidence rates of the specific groups by those of the general population. The study examined three categories: total crashes, total convictions, and major convictions. Additionally, the researchers considered a subgroup of mandatory cases who regained their driving privileges (approximately 13% of the mandatory group) and compared them to the broader mandatory and voluntary groups. Key findings revealed distinct risk profiles for different groups. Prior to suspension, the "All Mandatory" group exhibited a crash incidence of 40% and a total conviction incidence of 60% relative to the general population, but a major conviction incidence of 200%. The subgroup of mandatory drivers who were subsequently re-licensed showed comparably greater pre-suspension safety risks. Voluntary referrals had a relatively high incidence of pre-suspension crashes. Post-suspension, the relative safety risk for the "All Mandatory" group increased. Notably, the re-licensed subgroup experienced significant growth in relative safety risk, particularly regarding crashes. Conversely, voluntary referrals saw a decline in crash risk but an increase in major conviction risk after suspension. A critical finding was that a crash occurring in the 18 months prior to suspension was a significant predictor of post-suspension crashes. The study concludes that the current program can be improved through several strategies. First, crash history should be utilized in evaluating applications for reinstating driving privileges, and subsequent crashes should trigger re-certification or mandatory DMV testing. Second, the authors suggest adopting a tiered assessment model similar to a California pilot program, which uses structured observations and tailored driving exams to identify moderate impairments that pose significant safety risks. Finally, stakeholder interviews indicated that program effectiveness could be enhanced by increasing outreach to primary care providers, expanding insurance coverage for driving assessments, and merging voluntary and mandatory databases to better manage driver migration between programs.

Key finding

A crash during the 18-month period before license suspension was a significant predictor of a crash occurring after suspension among medically at-risk drivers.

Sample size: 1556

Provenance

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Topics

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• licensing policy
• driver education effectiveness
• induced exposure
• novice drivers
• older driver retraining

Information type

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• Applied Guidance: countermeasure evaluation, policy recommendations
• Empirical Findings: crash risk outcomes