Medical Review Data: Occupational Therapy Driver Assessments

Accurate data regarding the medical review process is critical in order for VicRoads to develop strategies to better identify and manage at-risk drivers. Of particular importance is benchmarking to measure increases in referral numbers and types of drivers following implementation of strategy elements. Thus, the aim of this research was to collect baseline data by developing a database for Medical Review data, and describing the characteristics of the medical review process for a sample of cases. The specific objectives of this research were to: (i) determine the prevalence of different types of medical conditions or impairments amongst Review Driver Test cases in the Medical Review database, and compare with the prevalence of these conditions in the adult population; (ii) link records with crash data for Medical Review cases; (iii) link and describe the licence outcomes for Medical Review cases, and; (iv) to the extent possible, describe the characteristics of Medical Review cases, including referral sources, reasons for referral, and the medical review process.The cohort comprised 150 cases that were predominantly male (66%) with a mean age of 62.4 years (range 16-93 years). Referral information in this group was hard to elicit, and this is likely to reflect that many of the OTDA cases will have been referred directly from rehabilitation services, and thus there will be no direct referral information contained in the file that is available for coding. Where referral information was available, it was most likely from a medical professional as a result of a medical condition. Where the licence outcome was known, around three quarters of the sample retained their driving licence in either a conditional or unconditional capacity, and the majority of these cases retained their licence subject to periodic review. Conditional licences were used frequently in this group, with the most common being automatic transmission, use of corrective lenses while driving, and local area restrictions. A small number of cases crashed following referral to Medical Review (a minimum of 12 months post-referral). Interestingly, it was found that these cases were relatively young, with a mean age of 36 years. The majority of cases had at least one medical condition, and many had multiple medical conditions. These medical conditions were compared with population prevalence data, however the sample characteristics with respect to age and gender make interpretation and meaningful comparisons with the general population difficult. Although the sample size in the current study is limited, some interesting avenues for further research emerged. Firstly, it would be valuable to investigate crashes in a larger sample, particularly the circumstances around crashes prior to and following referral to medical review. The safety benefits of the medical review process could also be evaluated by analysing the extent of crash involvement of those drivers deemed fit to continue driving with either unconditional or restricted licences. It would also be interesting to explore whether minor collisions are a valid referral trigger for a medical review process. Secondly, it was found that a large proportion of cases retained their licence subject to periodic review, and further evaluation of the cost-effectiveness and benefits of this process are warranted.