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A decision analytic model to investigate the cost-effectiveness of poisoning prevention practices in households with young children

Achana, Felix; Sutton, Alex J.; Kendrick, Denise; Hayes, Mike; Jones, David R.; Hubbard, Stephanie J.; Cooper, Nicola J.

Authors

Felix Achana

Alex J. Sutton

DENISE KENDRICK denise.kendrick@nottingham.ac.uk
Professor of Primary Care Research

Mike Hayes

David R. Jones

Stephanie J. Hubbard

Nicola J. Cooper



Abstract

Background: Systematic reviews and a network meta-analysis show home safety education with or without the provision of safety equipment is effective in promoting poison prevention behaviours in households with children. This paper compares the cost-effectiveness of home safety interventions to promote poison prevention practices.


Methods: A probabilistic decision-analytic model simulates healthcare costs and benefits for a hypothetical cohort of under 5 year olds. The model compares the cost-effectiveness of home safety education, home safety inspections, provision of free or low cost safety equipment and fitting of equipment. Analyses are conducted from a UK National Health Service and Personal Social Services perspective and expressed in 2012 prices.


Results: Education without safety inspection, provision or fitting of equipment was the most cost-effective strategy for promoting safe storage of medicines with an incremental cost-effectiveness ratio of £2888 (95 % credible interval (CrI) £1990–£5774) per poison case avoided or £41,330 (95%CrI £20,007–£91,534) per QALY gained compared with usual care. Compared to usual care, home safety interventions were not cost-effective in promoting safe storage of other household products.


Conclusion: Education offers better value for money than more intensive but expensive strategies for preventing medicinal poisonings, but is only likely to be cost-effective at £30,000 per QALY gained for families in disadvantaged areas and for those with more than one child. There was considerable uncertainty in cost-effectiveness estimates due to paucity of evidence on model parameters. Policy makers should consider both costs and effectiveness of competing interventions to ensure efficient use of resources.

Citation

Achana, F., Sutton, A. J., Kendrick, D., Hayes, M., Jones, D. R., Hubbard, S. J., & Cooper, N. J. (2016). A decision analytic model to investigate the cost-effectiveness of poisoning prevention practices in households with young children. BMC Public Health, 16, https://doi.org/10.1186/s12889-016-3334-0

Journal Article Type Article
Acceptance Date Jul 21, 2016
Publication Date Aug 3, 2016
Deposit Date Aug 24, 2016
Publicly Available Date Aug 24, 2016
Journal BMC Public Health
Electronic ISSN 1471-2458
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 16
Article Number 705
DOI https://doi.org/10.1186/s12889-016-3334-0
Keywords Economic evaluation; Public health; Injury prevention; Poisonings; Children; Decision models
Public URL http://eprints.nottingham.ac.uk/id/eprint/35990
Publisher URL http://dx.doi.org/10.1186/s12889-016-3334-0
Related Public URLs https://creativecommons.org/licenses/by/4.0/
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0





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