In the U.S., drowning is the 3rd leading cause of unintentional injury death. Every year, some 5,000 individuals drown and an estimated 88,000 suffer near-drowning episodes. A substantial number of these events occur while enjoying recreational activities in swimming pools or boats. Our objective was to characterize the cost-effectiveness of: Fencing of residential in-ground swimming pools, covering of residential above-ground swimming pools, and use of personal flotation devices (PFDs) in recreational boats. We collected data from the existing literature or from surveys of manufacturers and safety experts. Cost-effectiveness was computed following the recommendations of the US Panel on Cost-Effectiveness in Medicine. The numerators summarize the net costs of the intervention (1999 US $) and the denominators indicate the net health benefits (combining mortality and morbidity in Quality-Adjusted Life Years). Fencing of residential pools in homes with children less than 18 years old resulted in cost effectiveness ratios ranging from $25,000 to $31,000 per QALY gained depending on whether the fenced pools belonged to homes with children of different age subgroups and whether an incremental installation was being considered. PFDs resulted in ratios of $4,000 per QALY gained. Sensitivity analysis was conducted to evaluate the robustness of the findings. Fencing of in-ground pools in homes with children less than 18 years old and purchasing of PFDs for boats results in cost effectiveness well below that of numerously implemented interventions in the clinical and public health realm. In contrast, fencing of all residential pools and covering of leads has much higher ratios
Learning Objectives: N/A
Keywords: Injury Prevention, Economic Analysis
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