Cost-effectiveness of interventions for increasing the possession of functioning smoke alarms in households with pre-school children: a modelling study

Saramago, Pedro; Cooper, Nicola J.; Sutton, Alex J.; Hayes, Mike; Dunn, Ken; Manca, Andrea; Kendrick, Denise

Abstract

Background

The UK has one of the highest rates for deaths from fire and flames in children aged 0-14 years compared to other high income countries. Evidence shows that smoke alarms can reduce the risk of fire-related injury but little exists on their cost-effectiveness. We aimed to compare the cost effectiveness of different interventions for the uptake of 'functioning' smoke alarms and consequently for the prevention of fire-related injuries in children in the UK.

Methods

We carried out a decision model-based probabilistic cost-effectiveness analysis. We used a hypothetical population of newborns and evaluated the impact of living in a household with or without a functioning smoke alarm during the first 5 years of their life on overall lifetime costs and quality of life from a public health perspective. We compared seven interventions, ranging from usual care to more complex interventions comprising of education, free/low cost equipment giveaway, equipment fitting and/or home safety inspection.

Results

Education and free/low cost equipment was the most cost-effective intervention with an estimated incremental cost-effectiveness ratio of [pound sign]34,200 per QALY gained compared to usual care. This was reduced to approximately £4,500 per QALY gained when 1.8 children under the age of 5 were assumed per household.


Conclusions


Assessing cost-effectiveness, as well as effectiveness, is important in a public sector system operating under a fixed budget restraint. As highlighted in this study, the more effective interventions (in this case the more complex interventions) may not necessarily be the ones considered the most cost-effective.

Citation

Saramago, P., Cooper, N. J., Sutton, A. J., Hayes, M., Dunn, K., Manca, A., & Kendrick, D. (2014). Cost-effectiveness of interventions for increasing the possession of functioning smoke alarms in households with pre-school children: a modelling study. BMC Public Health, 14, Article 459. https://doi.org/10.1186/1471-2458-14-459

• Journal Article Type: Article
• Acceptance Date: Apr 24, 2014
• Publication Date: May 16, 2014
• Deposit Date: May 26, 2016
• Publicly Available Date: May 26, 2016
• Journal: BMC Public Health
• Electronic ISSN: 1471-2458
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 14
• Article Number: 459
• DOI: https://doi.org/10.1186/1471-2458-14-459
• Keywords: Cost-effectiveness analysis; Smoke alarms; Decision model; Fire-related injuries; Child home injuries
• Public URL: https://nottingham-repository.worktribe.com/output/728524
• Publisher URL: http://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-14-459
• Related Public URLs: https://creativecommons.org/licenses/by/2.0