Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #113504

J.A. Goldstein, BA, School of Medicine, University of Pennsylvania, 229 S 22nd Street, Philadelphia, PA 19103, 215 731 9499, goldsteinj@email.chop.edu, Charles Branas, PhD, Department of Biostatistics and Epidemiology, University of Pennsylvania, Room 829 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021, Ted R. Miller, PhD, Pacific Institute for Research and Evaluation, 11710 Beltsville Drive, Suite 300, Calverton, MD 20705-3102, Michael J. Kallan, MS, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, 523 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, J. Sanford Schwartz, MD, Department of Internal Medicine, University of Pennsylvania, 1120 Blockley Hall, Philadelphia, PA 19104, and Flaura K. Winston, MD, PhD, TraumaLink, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, 3535 TraumaLink, 10th Floor, Philadelphia, PA 19104.

BACKGROUND: Low-income children are disproportionately at risk for preventable injury compared to children of higher socioeconomic status, placing substantial economic burden on state Medicaid programs. Child restraint systems (CRS) have demonstrated efficacy in preventing death/injury among children in crashes but remain underutilized by these families, in part because of poor access to these devices.

OBJECTIVE: To examine the cost-effectiveness of Medicaid reimbursement for CRS disbursement/education for low-income children.

METHODS: Cost-effectiveness analysis based on data from the Partners for Child Passenger Safety database and the Fatal Accident Reporting Systems and other published and unpublished sources. Main outcomes measured include cost per life-year, death, serious injury, and minor injury averted, as well as medical, parental work loss, and future productivity loss costs averted.

RESULTS: Per 100,000 low-income children, the adoption of a CRS disbursement/education program could prevent as many as six deaths, 11 serious injuries, and 47 minor injuries annually. When fully implemented, the program could initially save Medicaid over $1 million/100,000 children in direct medical costs while costing $60/child to administer. It would cost only $10/child over all eight years of benefit. From the perspective of Medicaid, the program would cost $5500/life-year saved, $61,000/serious injury, and $180,000/death averted while being cost saving from a societal perspective.

CONCLUSION: Implementation of a Medicaid-funded CRS disbursement/education program is an important strategy for addressing injury disparities among low-income children. It demonstrates parity with the cost-effectiveness of existing prevention programs, including many vaccines covered by the Federally-financed Vaccines-For-Children program targeted towards similar populations.

Learning Objectives:

• Recognize disparities in prevention of pediatric motor vehicle injuries.
• Assess importance of a large-scale approach to addressing these disparities.
• Evaluate the benefit of reducing injuries and deaths from motor vehicle crashes.

Keywords: Cost-Effectiveness, Injury Prevention

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation