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

TitleAn economic evaluation of setting up physical barriers in railway stations for preventing railway injury: Evidence from Hong Kong
Authors
Issue Date2011
PublisherBMJ 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?
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.
Persistent Identifierhttp://hdl.handle.net/10722/172273
ISSN
2015 Impact Factor: 3.865
2015 SCImago Journal Rankings: 1.890
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLaw, CKen_US
dc.contributor.authorYip, PSFen_US
dc.date.accessioned2012-10-30T06:21:07Z-
dc.date.available2012-10-30T06:21:07Z-
dc.date.issued2011en_US
dc.identifier.citationJournal of Epidemiology and Community Health, 2011, v. 65 n. 10, p. 915-920en_US
dc.identifier.issn0143-005Xen_US
dc.identifier.urihttp://hdl.handle.net/10722/172273-
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.en_US
dc.languageengen_US
dc.publisherBMJ Publishing Group. The Journal's web site is located at http://jech.bmjjournals.com/en_US
dc.relation.ispartofJournal of Epidemiology and Community Healthen_US
dc.subject.meshArchitectural Accessibility - Economics - Methodsen_US
dc.subject.meshCost-Benefit Analysisen_US
dc.subject.meshDatabases, Factualen_US
dc.subject.meshHong Kongen_US
dc.subject.meshHumansen_US
dc.subject.meshRailroadsen_US
dc.subject.meshSafety Management - Economicsen_US
dc.subject.meshWounds And Injuries - Prevention & Controlen_US
dc.titleAn economic evaluation of setting up physical barriers in railway stations for preventing railway injury: Evidence from Hong Kongen_US
dc.typeArticleen_US
dc.identifier.emailYip, PSF: sfpyip@hku.hken_US
dc.identifier.authorityYip, PSF=rp00596en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1136/jech.2010.115188en_US
dc.identifier.pmid21282146-
dc.identifier.scopuseid_2-s2.0-80955166402en_US
dc.identifier.hkuros211187-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-80955166402&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume65en_US
dc.identifier.issue10en_US
dc.identifier.spage915en_US
dc.identifier.epage920en_US
dc.identifier.isiWOS:000294720300014-
dc.publisher.placeUnited Kingdomen_US
dc.identifier.scopusauthoridLaw, CK=26027038700en_US
dc.identifier.scopusauthoridYip, PSF=7102503720en_US

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