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Medicaid-based child restraint system disbursement and education and the vaccines for children program: comparative
Jesse A Goldstein1, Flaura K Winston, Michael J Kallan
1School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA. jessegoldstein@alumni.upenn.edu
Insights
Medicaid funding for child restraint systems (CRSs) and education is cost-effective for low-income children, preventing injuries and saving lives. This program offers comparable benefits to vaccination initiatives, addressing critical injury disparities.
Area of Science:
- Public Health
- Injury Prevention
- Health Economics
Background:
- Low-income children face disproportionately high risks of motor-vehicle injuries.
- Medicaid programs incur significant costs due to these preventable injuries.
- Child restraint systems (CRSs) are effective but underutilized due to access and education barriers.
Purpose of the Study:
- To evaluate the cost-effectiveness of Medicaid-funded CRS disbursement and education for low-income children.
- To compare this program's cost-effectiveness with the Vaccines For Children (VFC) program.
Main Methods:
- A cost-effectiveness analysis was conducted using public and private database data.
- Primary outcomes included life-years saved, averted deaths and injuries, and reduced medical/societal costs.
- Calculations were benchmarked against published data for VFC-covered vaccinations.
Main Results:
- A CRS program could prevent 2 deaths, 12 serious injuries, and 51 minor injuries per 100,000 children annually.
- The program could save Medicaid over $1 million per 100,000 children in direct medical costs.
- Cost per life-year saved was $17,000, comparable to vaccination programs.
Conclusions:
- Medicaid-funded CRS programs are a cost-effective strategy for injury prevention in low-income children.
- These programs demonstrate comparable cost-effectiveness to federal vaccination programs.
- This initiative can help mitigate injury disparities in vulnerable child populations.
Objective:
Low-income children are disproportionately at risk for preventable motor-vehicle injury. Many of these children are covered by Medicaid programs placing substantial economic burden on states. Child restraint systems (CRSs) have demonstrated efficacy in preventing death and injury among children in crashes but remain underutilized because of poor access and education. The objective of this study was to evaluate the cost-effectiveness of Medicaid-based reimbursement for CRS disbursement and education for low-income children and compare it with vaccinations covered under the Vaccines For Children (VFC) program.
Methods:
A cost-effectiveness analysis was performed of Medicaid reimbursement for CRS disbursement/education for low-income children based on data from public and private databases. Primary outcomes measured include cost per life-year saved, death, serious injury, and minor injury averted, as well as medical, parental work loss, and future productivity loss costs averted. Cost-effectiveness calculations were compared with published cost-effectiveness data for vaccinations covered under the VFC program.
Results:
The adoption of a CRS disbursement/education program could prevent up to 2 deaths, 12 serious injuries, and 51 minor injuries per 100,000 low-income children annually. When fully implemented, the program could save Medicaid over $1 million per 100,000 children in direct medical costs while costing $13 per child per year after all 8 years of benefit. From the perspective of Medicaid, the program would cost $17,000 per life-year saved, $60,000 per serious injury prevented, and $560,000 per death averted. The program would be cost saving from a societal perspective. These data are similar to published vaccination cost-effectiveness data.
Conclusion:
Implementation of a Medicaid-funded CRS disbursement/education program was comparable in cost-effectiveness with federal vaccination programs targeted toward similar populations and represents an important potential strategy for addressing injury disparities among low-income children.
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