Article: An economic evaluation of setting up physical barriers in railway stations for preventing railway injury: Evidence from Hong Kong
| Title | An economic evaluation of setting up physical barriers in railway stations for preventing railway injury: Evidence from Hong Kong |
|---|---|
| Authors | Law, CK2 Yip, PSF1 |
| Issue Date | 2011 |
| Publisher | BMJ Publishing Group. The Journal's web site is located at http://jech.bmjjournals.com/ |
| Citation | Journal of Epidemiology and Community Health, 2011, v. 65 n. 10, p. 915-920 [How to Cite?] DOI: http://dx.doi.org/10.1136/jech.2010.115188 |
| Abstract | Background: Setting physical barriers, for example platform screen doors (PSDs), has been proven to be effective in preventing falls onto railway tracks, but its cost-effectiveness is not known. For economic evaluation of public health interventions, the importance of including non-health factors has been noted despite a lack of empirical studies. This study aimed to investigate the effectiveness and cost-effectiveness of PSDs, which are installed in part of the Hong Kong railway system, for preventing railway injuries. Methods: Data on railway injuries from 1997 to 2007 were obtained from the railway operators. Poisson regression was used to examine the risk reduction. Two incremental cost-effectiveness ratios (ICER) were calculated to assess the cost-effectiveness based on (1) disability-adjusted life years (DALYs) only and (2) DALYs with potential fare revenue and passengers' waiting time lost due to railway circulation collapse. Results: The PSD installation has effectively reduced railway injuries (adjusted 5-year average percentage change: -68.8%, p<0.0001) with no apparent substitution effect to the other platforms observed. To be cost-effective, the cost of gaining a healthy life year (ICER) should not exceed three times the per capita GDP (US$74 700). The PSD installation would only be cost-effective if the loss of fare revenue and passengers' waiting time, in addition to DALY, were included (ICER: US$65 400), while the ICER based on DALY only would be US$77 900. Conclusion: The challenges of complexity for economic evaluation appear in many community-based health interventions. A more extensive perspective for exploring other outcome measurements and evaluation methods to reflect a fair and appropriate value of the intervention's cost-effectiveness is needed. |
| ISSN | 0143-005X 2011 Impact Factor: 3.192 2011 SCImago Journal Rankings: 0.166 |
| DOI | http://dx.doi.org/10.1136/jech.2010.115188 |
| References | References in Scopus |
| dc.contributor.author | Law, CK |
|---|---|
| dc.contributor.author | Yip, PSF |
| dc.date.accessioned | 2012-10-30T06:21:07Z |
| dc.date.available | 2012-10-30T06:21:07Z |
| dc.date.issued | 2011 |
| dc.description.abstract | Background: Setting physical barriers, for example platform screen doors (PSDs), has been proven to be effective in preventing falls onto railway tracks, but its cost-effectiveness is not known. For economic evaluation of public health interventions, the importance of including non-health factors has been noted despite a lack of empirical studies. This study aimed to investigate the effectiveness and cost-effectiveness of PSDs, which are installed in part of the Hong Kong railway system, for preventing railway injuries. Methods: Data on railway injuries from 1997 to 2007 were obtained from the railway operators. Poisson regression was used to examine the risk reduction. Two incremental cost-effectiveness ratios (ICER) were calculated to assess the cost-effectiveness based on (1) disability-adjusted life years (DALYs) only and (2) DALYs with potential fare revenue and passengers' waiting time lost due to railway circulation collapse. Results: The PSD installation has effectively reduced railway injuries (adjusted 5-year average percentage change: -68.8%, p<0.0001) with no apparent substitution effect to the other platforms observed. To be cost-effective, the cost of gaining a healthy life year (ICER) should not exceed three times the per capita GDP (US$74 700). The PSD installation would only be cost-effective if the loss of fare revenue and passengers' waiting time, in addition to DALY, were included (ICER: US$65 400), while the ICER based on DALY only would be US$77 900. Conclusion: The challenges of complexity for economic evaluation appear in many community-based health interventions. A more extensive perspective for exploring other outcome measurements and evaluation methods to reflect a fair and appropriate value of the intervention's cost-effectiveness is needed. |
| dc.description.nature | Link_to_subscribed_fulltext |
| dc.identifier.citation | Journal of Epidemiology and Community Health, 2011, v. 65 n. 10, p. 915-920 [How to Cite?] DOI: http://dx.doi.org/10.1136/jech.2010.115188 |
| dc.identifier.doi | http://dx.doi.org/10.1136/jech.2010.115188 |
| dc.identifier.epage | 920 |
| dc.identifier.hkuros | 211187 |
| dc.identifier.issn | 0143-005X 2011 Impact Factor: 3.192 2011 SCImago Journal Rankings: 0.166 |
| dc.identifier.issue | 10 |
| dc.identifier.pmid | 21282146 |
| dc.identifier.scopus | eid_2-s2.0-80955166402 |
| dc.identifier.spage | 915 |
| dc.identifier.uri | http://hdl.handle.net/10722/172273 |
| dc.identifier.volume | 65 |
| dc.language | eng |
| dc.publisher | BMJ Publishing Group. The Journal's web site is located at http://jech.bmjjournals.com/ |
| dc.publisher.place | United Kingdom |
| dc.relation.ispartof | Journal of Epidemiology and Community Health |
| dc.relation.references | References in Scopus |
| dc.subject.mesh | Architectural Accessibility - Economics - Methods |
| dc.subject.mesh | Cost-Benefit Analysis |
| dc.subject.mesh | Databases, Factual |
| dc.subject.mesh | Hong Kong |
| dc.subject.mesh | Humans |
| dc.subject.mesh | Railroads |
| dc.subject.mesh | Safety Management - Economics |
| dc.subject.mesh | Wounds And Injuries - Prevention & Control |
| dc.title | An economic evaluation of setting up physical barriers in railway stations for preventing railway injury: Evidence from Hong Kong |
| dc.type | Article |
Author Affiliations
- The University of Hong Kong
- Chinese University of Hong Kong

