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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
2013 Impact Factor: 3.294
 
DOIhttp://dx.doi.org/10.1136/jech.2010.115188
 
ReferencesReferences in Scopus
 
DC FieldValue
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
2013 Impact Factor: 3.294
 
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
 
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<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&apos; 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&lt;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&apos; 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&apos;s cost-effectiveness is needed.</description.abstract>
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Author Affiliations
  1. The University of Hong Kong
  2. Chinese University of Hong Kong