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A maternity hospital-based infant car-restraint loan scheme: Public health and economic evaluation of an intervention for the reduction of road traffic injuries

Department of Hygiene and Epidemiology, Athens University Medical School, Athens, Greece

Maria Belechri

Department of Hygiene and Epidemiology, Athens University Medical School, Athens, Greece

Xanthi Dedoukou

Department of Hygiene and Epidemiology, Athens University Medical School, Athens, Greece

Themis Spyridopoulos

Department of Hygiene and Epidemiology, Athens University Medical School, Athens, Greece

Delia-Marina Alexe

Department of Hygiene and Epidemiology, Athens University Medical School, Athens, Greece

Evanthia Pappa

Department of Hygiene and Epidemiology, Athens University Medical School, Athens, Greece

Asimoula Stamou

Department of Psychoprophylaxis, Alexandra University Hospital, Maternal Unit, Athens, Greece

Eleni Petridou

Department of Hygiene and Epidemiology, Athens University Medical School, Athens, Greece, epetrid{at}med.uoa.gr

Aims: The results of an infant car-restraint loan scheme and evaluate its cost-effectiveness are presented. Methods: The intervention programme was initiated in 1996. Car-restraints, donated by manufacturers, were lent for a six-month period to eligible prospective parents for a modest fee. Specially trained health visitors performed in-person interviews with the participating parents. The data were collected and recorded on a pre-coded questionnaire. Cross-tabulations and multiple logistic regression were performed to analyse the data. Subsequent purchase of a next-stage car restraint, suitable for older children (up to four years of age) was considered as a proxy measure of the success of the programme. This information, along with the detailed operational and financial data collected during the implementation phase of the programme, was used to develop a model to assess the cost-effectiveness of a countrywide intervention. Results: During a two-year period 188 families participated in a survey. On return of the infant car restraint, 92% of the participants reported proper use of the device and 82% had already purchased the second-stage car restraint. Parental age, gender, or educational status was not predictive of positive parental road safety practices for the newly born, whereas history of parental seat-belt use — as a proxy of personal road safety behaviour — was positively correlated with the likelihood of purchasing a second-stage car-restraint device. The cost-effectiveness ratio varies between 418.00 and 3,225.00 per life-year saved, depending on whether the modest administrative fee is considered. Conclusions: On the basis of plausible assumptions, a loan programme of infant car-restraints was shown to be particularly cost effective.

Key Words: car-restraint devices • cost-effectiveness • intervention • loan

Scandinavian Journal of Public Health, Vol. 33, No. 1, 42-49 (2005)
DOI: 10.1080/14034940410028334


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