Cost-effectiveness of interventions for increasing the possession of functioning smoke alarms in households with
Pedro Saramago, Nicola J Cooper1, Alex J Sutton
1Department of Health Sciences, University of Leicester, 2nd Floor Adrian Building, University Road, Leicester LE1 7RH, UK. njc21@leicester.ac.uk.
Insights
Implementing education and free smoke alarms is the most cost-effective way to prevent child fire injuries in the UK. This intervention significantly reduces risks and improves quality-adjusted life years (QALYs) for children.
Area of Science:
- Public Health
- Health Economics
- Child Safety
Background:
- The UK faces high rates of fire-related deaths in children (0-14 years) compared to similar nations.
- Smoke alarms are proven to reduce fire injury risks, but their cost-effectiveness for child safety is understudied.
- This research addresses the economic evaluation of interventions promoting functional smoke alarm uptake.
Purpose of the Study:
- To compare the cost-effectiveness of various interventions aimed at increasing the use of functioning smoke alarms.
- To evaluate the impact of these interventions on preventing fire-related injuries in children within the UK.
- To inform public health policy regarding child fire safety initiatives.
Main Methods:
- A decision model-based probabilistic cost-effectiveness analysis was conducted.
- A hypothetical cohort of newborns was studied over their lifetime, focusing on the first 5 years with or without a functioning smoke alarm.
- Seven interventions, from usual care to comprehensive packages (education, equipment, fitting, inspection), were compared.
Main Results:
- The most cost-effective intervention involved education combined with free/low-cost equipment, yielding an incremental cost-effectiveness ratio (ICER) of £34,200 per QALY gained versus usual care.
- The ICER decreased substantially to approximately £4,500 per QALY gained when assuming 1.8 children under 5 per household.
- This highlights the significant impact of household size on cost-effectiveness.
Conclusions:
- Cost-effectiveness analysis is crucial for public sector resource allocation under budget constraints.
- More effective interventions are not always the most cost-effective.
- Targeted strategies, like education and equipment provision, offer a strong value for money in child fire injury prevention.
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 £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.
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