changes in Britain while Cales & Trunkey (1985) discuss the ability of improved trauma care
systems to reduce fatalities. Treatment of traumatic brain injury has also undergone
significant advances over the last 30 years, including the introduction of clinical tools such as
CT scanners, which were introduced in the 1970’s (Gentleman, 1999).
New medical technologies tend to both increase and decrease health care expenditures
(Weisbrod, 1991). Poorly understood diseases or conditions generally trigger minor health
care expenditures since there are no technologies for treatment. Some technologies that can
decrease mortality can be quite costly, such as organ transplantations. The most advanced
technical solutions can actually be quite inexpensive as they tend to prevent diseases (for
example, vaccinations) or in the case of traffic-related injuries, prevent fatalities (for
example, seat-belts).1 This naturally makes it difficult to clearly define health care
expenditures as representing improvements in medical technology. Weisbrod (1991)
elaborates upon the difficulties of defining medical technologies and how they ultimately
effect quality of life, which in itself is a difficult output to measure. In any case, it would be
misleading to use a health care expenditure variable as a proxy for medical technology
improvements, as they may not be clearly linked.
With regard to changes that can specifically impact on the outcome of traffic accident
victims, the development of accident and emergency medicine has played a role. It plays an
important part in the care of acutely ill and injured patients especially from road accidents.
One specific example of a change in medical technology associated with emergency medicine
is computer based storage systems for clinical images, radiographs, photographs, and ECGs
that can help in teaching and research within an accident and emergency department (Clegg
et al., 2001). These technical improvements have clearly evolved over time enabling
emergency medical facilities to reduce mortality rates amongst accident victims. In the UK,
1 Some may not define seat-belts as a “medical technology” but clearly this illustrates the difficulty of defining
an index for change over time.