Cost-outcome analysis in injury prevention and control - Eighty-four recent estimates for the United States
Cost-outcome analysis in injury prevention and control - Eighty-four recent estimates for the United States
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DOI：
10.1097/00005650-200006000-00003
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发表时间：
2000-06-01
期刊：
影响因子：
3
通讯作者：
Levy, DT
中科院分区：
文献类型：
--
作者：
Miller, TR;Levy, DT
目标。这项研究的目标是回顾伤害预防和控制中的成本-结果分析，并估计相关的效益-成本比和每质量调整生命年的成本。Medline和互联网搜索、书目审查和联邦机构联系人确定了1987至1998年间美国已发表和未发表的研究。低质量的研究和对职业、航空、铁路和水上运输安全计划的分析被排除在外。测量：选择的结果被重新计算，以增加贴现率、福利类别和福利估计的可比性，并更新伤害发生率。结果：在所审查的84项伤害预防措施中，超过一半产生了净社会成本节约。有12项措施的成本超过了收益。在分析的33项道路安全措施中，有19项产生了净成本节约。在所研究的34种暴力预防方法中，19种产生了净成本节约，而8种成本超过了收益。受益-成本比最高的干预措施包括青少年犯罪治疗计划、防火香烟、联邦道路和交通安全计划资金、道路上绘制的车道标志、危险曲线上的立柱反光板、前排座椅上的安全带、主要执法的安全带法律、儿童安全座椅、儿童自行车头盔、禁止向醉酒者提供酒精的执法、药物滥用治疗、对酗酒者进行短暂的医疗干预，以及在低收入社区开展全面的安全社区计划。目前尚不存在针对几种损伤类型的节约成本措施的研究。结论：损伤预防通常可以降低医疗成本并挽救生命。有必要更广泛地实施行之有效的措施。
OBJECTIVES. The objectives of this study were to review cost-outcome analyses in injury prevention and control and estimate associated benefit-cost ratios and cost per quality-adjusted life-year.DATA SOURCES. Medline and Internet search, bibliographic review, and federal agency contacts identified published and unpublished studies from 1987 to 1998 for the United States. Studies of low quality and analyses of occupational, air, rail, and water transport safety programs were excluded.MEASURES. Selected results were recomputed to increase discount rate, benefit category, and benefit estimate comparability and to update injury incidence rates.RESULTS. More than half of the 84 injury prevention measures reviewed yielded net societal cost savings. Twelve measures had costs that exceeded benefits. Of 33 road safety measures analyzed, 19 yielded net cost savings. Of 34 violence prevention approaches studied, 19 yielded net cost savings, whereas 8 had costs that exceeded benefits. Interventions with the highest benefit-cost ratios included juvenile delinquent therapy programs, fire-safe cigarettes, federal road and traffic safety program funding, lane markers painted on roads, post-mounted reflectors on hazardous curves, safety belts in front seats, safety belt laws with primary enforcement, child safety seats, child bicycle helmets, enforcement of laws against serving alcohol to the intoxicated, substance abuse treatment, brief medical interventions with heavy drinkers, and a comprehensive safe communities program in a low-income neighborhood. Studies of cost-saving measures do not exist for several injury types.CONCLUSIONS. Injury prevention often can reduce medical costs and save lives. Wider implementation of proven measures is warranted.