Article: An economic evaluation of setting up physical barriers in railway stations for preventing railway injury: Evidence from Hong Kong

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TitleAn economic evaluation of setting up physical barriers in railway stations for preventing railway injury: Evidence from Hong Kong
AuthorsLaw, CK2
Yip, PSF1
Issue Date2011
PublisherBMJ Publishing Group. The Journal's web site is located at http://jech.bmjjournals.com/
CitationJournal 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
AbstractBackground: 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.
ISSN0143-005X
2011 Impact Factor: 3.192
2011 SCImago Journal Rankings: 0.166
DOIhttp://dx.doi.org/10.1136/jech.2010.115188
ReferencesReferences in Scopus
DC Field
Value
dc.contributor.authorLaw, CK
dc.contributor.authorYip, PSF
dc.date.accessioned2012-10-30T06:21:07Z
dc.date.available2012-10-30T06:21:07Z
dc.date.issued2011
dc.description.abstractBackground: 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.natureLink_to_subscribed_fulltext
dc.identifier.citationJournal 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.doihttp://dx.doi.org/10.1136/jech.2010.115188
dc.identifier.epage920
dc.identifier.hkuros211187
dc.identifier.issn0143-005X
2011 Impact Factor: 3.192
2011 SCImago Journal Rankings: 0.166
dc.identifier.issue10
dc.identifier.pmid21282146
dc.identifier.scopuseid_2-s2.0-80955166402
dc.identifier.spage915
dc.identifier.urihttp://hdl.handle.net/10722/172273
dc.identifier.volume65
dc.languageeng
dc.publisherBMJ Publishing Group. The Journal's web site is located at http://jech.bmjjournals.com/
dc.publisher.placeUnited Kingdom
dc.relation.ispartofJournal of Epidemiology and Community Health
dc.relation.referencesReferences in Scopus
dc.subject.meshArchitectural Accessibility - Economics - Methods
dc.subject.meshCost-Benefit Analysis
dc.subject.meshDatabases, Factual
dc.subject.meshHong Kong
dc.subject.meshHumans
dc.subject.meshRailroads
dc.subject.meshSafety Management - Economics
dc.subject.meshWounds And Injuries - Prevention & Control
dc.titleAn economic evaluation of setting up physical barriers in railway stations for preventing railway injury: Evidence from Hong Kong
dc.typeArticle
Author Affiliations
  1. The University of Hong Kong
  2. Chinese University of Hong Kong