The DOI matches its Crossref record.
Cost-Outcome Analysis of Booster Seats for Auto Occupants Aged 4 to 7 Years
Abstract
OBJECTIVES. The purpose of this work was to analyze the societal return on investment in booster seats and in laws requiring their use in the United States. Booster seats reduce crash-related injury. Their use is mandatory for vehicle occupants aged 4 to 7 years in most of the United States. This study estimates the injury cost savings attributable to booster seat use. METHODS. Seat cost came from pricing on the Web and at retailers. Costs of passing and enforcing a legal mandate were estimated as a percentage of the costs of seat use. Injury risk when belted absent a seat was computed from national probability samples of crashes in the last years before booster seats entered into general use (1993–1999). Published estimates were used of the percentage of reduction in injuries achieved with booster seats, the mix of diagnoses reduced, and injury cost by diagnosis. The computations used a 3% discount rate. We studied the net cost per quality-adjusted life year saved, benefit-cost ratio, and net savings per seat. RESULTS. A booster seat costs $30 plus $167 for maintenance and time spent on installation and use. This investment saves $1854 per seat, a return on investment of 9.4 to 1. Even lower bound estimates in sensitivity analysis indicated that society would benefit from the use of booster seats. Seat laws offer a return of 8.6 to 1. CONCLUSIONS. Belt-positioning booster seats offer a sound return on investment. Booster seat use laws should be passed, publicized, and enforced nationwide.
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The median CBR for legislative interventions was 5.8.
“The median CBR was 5.8 (range 310 to 8.616).”
From Return on investment of public health interventions: a systematic review (2017) · cites this paper as [16]
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Research works printed but not linked: 15
- Durbin DR, Arbogast KB, Moll EK. Seat belt syndrome in children: A case report and review of the literature. Pediatr Emerg Care. 2001;17;474–477 · DOI
- Ebel BE, Koepsell TD, Bennett EE, Rivera FP. Too small for a seatbelt: Predictors of booster seat use by child passengers. Pediatrics. 2003;111:323–327 · DOI
- Durbin DR, Elliott MR, Winston FK. Belt-positioning booster seats and reduction in risk of injury among children in vehicle crashes. JAMA. 2003;289;2835–2840 · DOI
- Miller TR, Pindus NM, Douglass JB, Rossman SB. Databook on Nonfatal Injury: Incidence, Costs, and Consequences. Washington, DC: The Urban Institute Press; 1995
- Miller TR. Costs and functional consequences of United States roadway crashes. Accid Anal Prev. 1993;25:593–607 · DOI
- Gold MR, Siegel JE, Russell LB, Weinstein MC, eds. Cost-Effectiveness in Health and Medicine. New York, NY: Oxford University Press; 1996 · DOI · Paper page
- Drummond MF, O'Brien B, Stoddart GL, Torrance GW. Methods for the Economic Evaluation of Health Care Programmes. 2nd ed. Oxford, United Kingdom: Oxford University Press; 1997
- Hendrie D, Miller TR, Orlando M, et al. Child and family safety device affordability by country income level: An 18-country comparison. Inj Prev. 2004;10;338–343 · DOI
- Miller TR. Assessing the burden of injury: Progress and pitfalls. In: Mohan D, Tiwari G, eds. Injury Prevention and Control. New York, NY: Taylor & Francis; 2000:49–70 · DOI
- Downing PB. Policy consequences of indirect regulatory costs. Public Policy. 1981;29:507–526
- Miller TR, Zaloshnja E, Sheppard MA. Are booster seats needed: Comparing occupant outcomes ages 4–7 versus 8–13. 46th Annual Conference of the Association for the Advancement of Automotive Medicine, Sep 29 to Oct 2, 2002. Barrington, IL: Association for the Advancement of Automotive Medicine; 2002:239–259
- Zaloshnja E, Miller TR, Romano EO, Spicer RS. Crash costs by body part injured, fracture involvement, and threat to life severity, United States, 2000. Accid Anal Prev. 2004;36;415–427 · DOI
- Miller TR, Levy DT. Cost-outcome analysis in injury prevention and control: Eighty-four recent estimates for the United States. Med Care. 2000;38;562–582 · DOI
- Zaza S, Sleet DA, Thompson RS, Sosin DM, Bolen JC. Reviews of evidence regarding interventions to increase use of child safety seats. Am J Prev Med. 2001;21(4 suppl):31–47 · DOI
- Blomquist G. Motorist use of safety equipment: Expected benefits or risk incompetence. J. Risk Unc. 1991;4:135–152 · DOI
Cited by
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Return on investment of public health interventions: a systematic review
Masters, R., Anwar, E., Collins, B., Cookson, R., & Capewell, S. (2017) · Journal of Epidemiology and Community Health · doi:10.1136/jech-2016-208141 · Cited by 480
Metadata
- Authors
- Miller, T. R., Zaloshnja, E., & Hendrie, D.
- Affiliations
- Pacific Institute For Research and Evaluation (US)
- The University of Western Australia (AU)
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2006-11-01
- Volume
- 118
- Issue
- 5
- Pages
- 1994-1998
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2027588471
- Cited by
- 20
- References
- 0
- Citations by year
- 2021: 1 · 2020: 1 · 2018: 1 · 2017: 1 · 2015: 2 · 2014: 1 · 2013: 1 · 2012: 1
- FWCI
- 3.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion)
- Funders
- U.S. Department of Health and Human Services
- U.S. Public Health Service (240-98-0006)
- Maternal and Child Health Bureau
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Injury Epidemiology and Prevention
- Physical Sciences › Engineering › Biomedical Engineering › Automotive and Human Injury Biomechanics
- Physical Sciences › Engineering › Safety, Risk, Reliability and Quality › Traffic and Road Safety
- Keywords
- booster seats, child passenger safety, occupant injury, return on investment, cost per quality-adjusted life year, benefit-cost ratio, injury prevention policy
- MeSH terms
- Child, Child, Preschool, Humans, Infant Equipment, Cost Savings
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