?url_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Adc&rft.relation=http%3A%2F%2Fd-scholarship-dev.library.pitt.edu%2F12018%2F&rft.title=Role+of+State+Driver+Licensing+Policies+and+Physician+Reporting+Laws+on+Older+Driver+Safety&rft.creator=Agimi%2C+Yll&rft.description=This+study+aimed+to+determine+the+effect+of+state+licensing+and+physician+reporting+requirements+on+older+driver+safety%2C+guided+by+hypotheses+that+states+with+stricter+requirements+would+result+in+lower+fatal+crash+rates%2C+lower+older+driver+crash+hospitalization+rates+and+a+lower+prevalence+of+dementia+among+those+hospitalized+compared+to+states+with+fewer+requirements.+Three+separate+studies+were+performed.+The+first+study+used+2004+to+2009+fatal+crashes+to+examine+the+effect+of+state+requirements+on+fatal+crash+incidence+rates+using+Generalized+Estimating+Equation+(GEE)+negative+binomial+regression+models.+The+second+study+compared+2004+to+2009+crash-related+hospitalizations+according+to+state+licensing+requirements%3B+with+hospitalization+incidence+rates+estimated+using+three+GEE+negative+binomial+regression+models.+The+third+study+examined+crash-related+hospitalized+drivers+to+estimate+the+effect+of+state+requirements+on+the+prevalence+of+dementia+using+logistic+regression+models.+Vision+testing+at+in+person+renewals+showed+consistent+association+with+lower+fatal+crash+rates%2C+lower+hospitalization+rates+and+a+lower+prevalence+of+dementia+among+those+hospitalized.+Vision+testing+was+especially+predictive+of+a+lower+crash+fatality+rate+among+drivers+ages+80+to+84+and+lower+dementia+prevalence+among+hospitalized+drivers+ages+60+to+69%2C+reaffirming+the+safety+benefits+of+vision+testing.+Physician+reporting+requirements%2C+mandated+or+legally+protected%2C+and+length+of+licensing+renewal+lacked+any+independent+association+with+fatal+crash+rates%2C+crash-hospitalization+rates+or+dementia+prevalence.%0D%0AThe+public+health+significance+of+this+research+is+its+finding+that+more+restrictions+on+driving+do+not+translate+in+lower+crash+rates+among+older+drivers.+This+research+informs+older+drivers%2C+their+families%2C+physicians+and+state+agencies+on+licensing+and+reporting+requirements+that+provide+safety+benefits+to+assist+their+safety+and+mobility+decisions.+It+also+informs+stakeholders+on+the+utility+of+screening+older+patient+drivers+and+demonstrates+the+need+for+improved+physician+tools+for+the+assessment+of+older+adult+driving+safety.&rft.date=2012-07-02&rft.type=University+of+Pittsburgh+ETD&rft.type=PeerReviewed&rft.format=application%2Fpdf&rft.language=en&rft.identifier=http%3A%2F%2Fd-scholarship-dev.library.pitt.edu%2F12018%2F1%2FAGIMIY_ETD2012.pdf&rft.identifier=++Agimi%2C+Yll++(2012)+Role+of+State+Driver+Licensing+Policies+and+Physician+Reporting+Laws+on+Older+Driver+Safety.++Doctoral+Dissertation%2C+University+of+Pittsburgh.++++(Unpublished)++