Cost-Effectiveness of an Injury and Drowning Prevention Program in Bangladesh
Cost-Effectiveness of an Injury and Drowning Prevention Program in Bangladesh
复制标题
DOI：
10.1542/peds.2012-0757
复制
发表时间：
2012-12-01
期刊：
影响因子：
8
通讯作者：
Finkelstein, Eric
中科院分区：
文献类型：
--
作者：
Rahman, Fazlur;Bose, Saideep;Finkelstein, Eric
目的：需要减轻发展中国家溺水风险的干预措施。这项研究提出了一个低成本，可扩展的伤害和溺水预防计划称为预防儿童伤害通过社会干预和教育（PRECISE）在孟加拉国的成本效益。2006年至2010年，PRECISE的两个组成部分在孟加拉国农村地区实施了两项计划（将儿童隔离在托儿所的“儿童安全”计划[n = 18 596名参与者]和教儿童如何游泳的“游泳安全”计划[n = 79 421名参与者]）。在回顾性队列分析中，将参与者的死亡率与非参与者的匹配样本进行比较。通过考克斯比例风险分析计算有效性。根据世界卫生组织选择干预措施是成本效益guidelines.RESULTS估计的成本效益：每个孩子每年的医疗成本在50.74美元和60.50美元之间。SwimSafe的费用为每位儿童13.46美元。对于有经验的参与者，溺水死亡的相对风险为0.181（P = .004）。全因死亡的相对危险度为0.56（P = 0.001）。对于SwimSafe，溺水死亡的相对风险为0.072（P < .0001）。全因死亡的相对风险为0.750（P = 0.024）。对于DALY，避免的每残疾调整生命年（DALY）成本为812美元（95%置信区间：589 - 1777美元）。对于SwimSafe，避免的每DALY成本为85美元（51 - 561美元）。合并后，避免的每个DALY的成本为362美元（232 - 1364美元）。结论：根据世界卫生组织的标准，PRECISE是非常具有成本效益的，应考虑在溺水是一个重大问题的其他地区实施。儿科2012;130：e1621-e1628
OBJECTIVE: Interventions that mitigate drowning risk in developing countries are needed. This study presents the cost-effectiveness of a low-cost, scalable injury and drowning prevention program called Prevention of Child Injuries through Social-Intervention and Education (PRECISE) in Bangladesh.METHODS: Between 2006 and 2010, the 2 components of PRECISE (Anchal, which sequestered children in creches [n = 18 596 participants], and SwimSafe, which taught children how to swim [n = 79421 participants]) were implemented in rural Bangladesh. Mortality rates for participants were compared against a matched sample of non-participants in a retrospective cohort analysis. Effectiveness was calculated via Cox proportional hazard analysis. Cost-effectiveness was estimated according to World Health Organization-CHOosing Interventions that are Cost Effective guidelines.RESULTS: Anchal costs between $50.74 and $60.50 per child per year. SwimSafe costs $13.46 per child. For Anchal participants, the relative risk of a drowning death was 0.181 (P = .004). The relative risk of all-cause mortality was 0.56 (P = .001). For SwimSafe, the relative risk of a drowning death was 0.072 (P < .0001). The relative risk of all-cause mortality was 0.750 (P = .024). For Anchal, the cost per disability-adjusted life-year (DALY) averted is $812 (95% confidence interval: $589-$1777). For SwimSafe, the cost per DALY averted is $85 ($51-$561). Combined, the cost per DALY averted is $362 ($232-$1364).CONCLUSIONS: Based on World Health Organization criteria, PRECISE is very cost-effective and should be considered for implementation in other areas where drowning is a significant problem. Pediatrics 2012;130:e1621-e1628