Cost-effectiveness of the ‘Stay One Step Ahead’ Home Safety programme for the prevention of injuries among children under 5 years

Jones, Matthew; Orton, Elizabeth; Taylor, Michael James; Timblin, Clare; Clarke, Rachel; Watson, Michael Craig; Hayes, Mike; Patel, Tina; Coupland, Carol; Kendrick, Denise

Abstract

Background Unintentional injuries are a common cause of morbidity and mortality in the under-5s, but undertaking home safety practices can reduce injury risk. Stay One Step Ahead (SOSA) is an evidence-based standardised home safety programme. This study evaluates the cost-effectiveness of SOSA versus usual care in Nottingham, UK.

Methods Cost-effectiveness analysis from a National Health Service and personal social services perspective. SOSA activity data, injury occurrence and associated short-term healthcare costs were collected within a controlled before-and-after study from 2017 to 2020. The primary outcome was the incremental cost-effectiveness ratio (ICER) per additional home adopting three key safety practices (working smoke alarm, safe poisons storage and fitted stair gate). Secondary outcomes were ICERs per injury avoided and quality-adjusted life-years (QALYs) gained.

Results SOSA costs £30 per child but reduces short-term healthcare expenditure by £42. SOSA increased the number of homes with three key safety practices by 0.02 per child, reduced injuries per child by 0.15 and gained 0.0036 QALYs per child. SOSA was dominant as it was cheaper and more effective than current practice. ICERs were −£590 per additional home deemed safe, −£77 per injury avoided and −£3225 per QALY gained. Focusing on healthcare expenditure alone, SOSA saved £1.39 for every pound spent.

Conclusions SOSA is a cost-saving intervention. Commissioners should consider implementing SOSA.

Citation

Jones, M., Orton, E., Taylor, M. J., Timblin, C., Clarke, R., Watson, M. C., Hayes, M., Patel, T., Coupland, C., & Kendrick, D. (2024). Cost-effectiveness of the ‘Stay One Step Ahead’ Home Safety programme for the prevention of injuries among children under 5 years. Injury Prevention, https://doi.org/10.1136/ip-2024-045236

• Journal Article Type: Article
• Acceptance Date: Apr 29, 2024
• Online Publication Date: Aug 31, 2024
• Publication Date: Aug 31, 2024
• Deposit Date: Sep 5, 2024
• Publicly Available Date: Sep 5, 2024
• Journal: Injury Prevention
• Print ISSN: 1353-8047
• Electronic ISSN: 1475-5785
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1136/ip-2024-045236
• Keywords: Interventions, Economic Analysis, Injury Diagnosis, Quality Of Life, Costs
• Public URL: https://nottingham-repository.worktribe.com/output/39171958
• Publisher URL: https://injuryprevention.bmj.com/content/early/2024/08/30/ip-2024-045236