Sure, they’re a quick and convenient solution to getting around congested cities, but e-scooters — dockless electrically powered scooters — often come with a host of problems, some of which can carry a hefty price tag. In one three-month study in Austin, the total cost burden was over $600,000. Based on these numbers, the annual charges for e-scooter injuries could come to around $4 million.
In particular, e-scooter-related injuries may have a large impact on regional health care costs. Several studies in the past few years have addressed some of the impact of e-scooter injuries, such as the types and severity, but only recently has a study investigated inpatient data and total hospital charges.
Cilla Parkison, a recent graduate of the Master of Science in Nursing Leadership in Diverse Settings (LeaDS) degree program, looked into how expensive these injuries are for residents of Austin, Texas. For her capstone project, under the direction of Lawrence Brown, PhD, her preceptor at Dell Medical School, she began to dig into the data.
This observational cohort study used the city of Austin’s public health syndromic surveillance system, an investigational approach in which health department staff are assisted by automated data acquisition to monitor disease indicators in real- or near real-time earlier than would otherwise be possible, to prospectively identify patients with e-scooter-related injuries. The medical and billing records for all adult patients treated at the two participating academic emergency departments were queried to extract demographic, clinical and cost data. Cost data included a single sum of total costs for all patients as well as detailed direct variable costs for each individual patient.
“Essentially, we used data from the city’s surveillance system and emergency medical services system to find injuries related to e-scooters between September and November 2018,” Cilla said. “After that, we asked the participating hospitals to query their data for cost information and received total charges, including ‘standard’ charges, but specific to each patient and diagnosis we only received ‘variable’ charges. Our goal was to quantify hospital charges and the cost burden that cities and taxpayers might bear.”
Cilla and Dr. Brown have since written an article they hope to publish early next year. Normally, after rolling out research results, students develop posters they can take to health care conferences, but the COVID 19 pandemic meant that many such conferences were cancelled in 2020.
As an alternative, Cilla entered the Three-Minute Thesis (3MT®) competition that provides a platform to showcase graduate student research. In total, 20 UT Austin students participated in the competition, with 10 individuals ultimately advancing and competing in the final round. Competitors are judged on the content of the presentation — both verbal content and PowerPoint slides — and how well they convey concepts and engage with the audience.
After competing in the final round with nine other researchers, Cilla credits the experience with helping her home in on the burden of the costs of these injuries and create a more compelling message to use to educate policymakers and the public.
“If you have insurance and you’re injured, then you might be okay getting your hospital charges covered,” she said. “But what if you don’t, or if a pedestrian is injured? Is it their fault? Currently there are no mandates for minimum insurance or helmet laws, and renting an e-scooter is relatively inexpensive. This low cost of entry belies the disproportionate cost of injury.”
Cilla is quick to explain that she is not opposed to e-scooters and supports micro-mobility, but also believes it’s important for policymakers and city governments to begin to address these associated costs. Fittingly, she currently works at an urgent care clinic and is applying to hospital residencies to pursue work in acute and, ideally, critical care.
“I hope our team has been able to bring awareness of the costs of these injuries to a broader audience and make the case for preparing accordingly; these costs impact all of us. We need to do the right thing for everyone.”