The Merseyside Accident Information Model (MAIM) can reveal components of accidents that lead to attendance at fracture clinics and cause disability:a new approach to accident prevention

The objectives of this study were to identify components of accidents that cause the most disability and to discover the principal sources of injuries treated in the fracture clinics. Patients attending fracture clinics of th e Royal Liverpool University Hospital were interviewed using a portable com puter-based questionnaire, the Merseyside Accident Information Model (MAIM) . Patients were followed up by telephone interview or letter to enquire abo ut disability continuing after discharge. Disability was measured by the pr e-accident to postdischarge changes in scores for 11 normal functions. Of t he 1326 patients interviewed, 900 (68%) were successfully followed up and 3 7% reported disability after discharge. First events 'tripping' 'slipping' and 'other underfoot events' accounted for 433 patients (194 reporting disa bility), and 'collapsed/fainted - no other event' for 66 patients (27 repor ting disability). Activities at the time of accident most frequently associ ated with disability involved moving about on foot. Among first event objec ts, ground surfaces and underfoot hazards were reported in 35%. Sources of injuries included underfoot accidents (48%), sport (13%), and transport acc idents (12%.). Underfoot accidents contributed to 58% of patients reporting disability, sport 6% and transport accidents 11%. Underfoot accidents toge ther with 'collapsed/fainted - no other event' accounted for 79% of female patients reporting disability and 50% of men. Such data could be used for c ost-effective targeting of preventative measures, and to study the effectiv eness of accident prevention initiatives. (C) 2000 Elsevier Science Ltd. Al l rights reserved.