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首页> 美国卫生研究院文献>British Medical Journal >Cost effectiveness of strategies to combat road traffic injuries in sub-Saharan Africa and South East Asia: mathematical modelling study
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Cost effectiveness of strategies to combat road traffic injuries in sub-Saharan Africa and South East Asia: mathematical modelling study

机译：撒哈拉以南非洲和东南亚地区打击道路交通伤害的策略的成本效益：数学模型研究

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>Objective To identify and estimate the population costs and effects of a selected set of enforcement strategies for reducing the burden of road traffic injuries in developing countries.>Design Cost effectiveness analysis based on an epidemiological model.>Setting Two epidemiologically defined World Health Organization sub-regions of the world: countries in sub-Saharan Africa with very high adult and high child mortality (AfrE); and countries in South East Asia with high adult and high child mortality (SearD).>Interventions Enforcement of speed limits via mobile speed cameras; drink-drive legislation and enforcement via breath testing campaigns; legislation and primary enforcement of seatbelt use in cars; legislation and enforcement of helmet use by motorcyclists; legislation and enforcement of helmet use by bicyclists.>Main outcome measures Patterns of injury were fitted to a state transition model to determine the expected population level effects of intervention over a 10 year period, which were expressed in disability adjusted life years (DALYs) averted. Costs were expressed in international dollars ($Int) for the year 2005. >Results The single most cost effective strategy varies by sub-region, but a combined intervention strategy that simultaneously enforces multiple road safety laws produces the most health gain for a given amount of investment. For example, the combined enforcement of speed limits, drink-driving laws, and motorcycle helmet use saves one DALY for a cost of $Int1000–3000 in the two sub-regions considered.>Conclusions The potential impact of available road safety measures is inextricably bound by the underlying distribution of road traffic injuries across different road user groups and risk factors. Combined enforcement strategies are expected to represent the most efficient way to reduce the burden of road traffic injuries, because they benefit from considerable synergies on the cost side while generating greater overall health gains.
机译：>目的，以识别和估算人口成本以及一系列旨在减少发展中国家道路交通伤害负担的执法策略的效果。>设计基于>设置：世界卫生组织在世界上两个流行病学分地区：撒哈拉以南非洲成人和儿童死亡率（AfrE）很高的国家； >干预：通过移动测速相机实施限速；通过呼气测试运动制定酒后驾车法规和执法；立法和主要执行汽车安全带的使用；立法和强制摩托车手使用头盔； >主要结局指标，将伤害模式与状态转换模型相匹配，以确定在10年内干预措施的预期人口水平影响，并以调整后的残疾表示生命年（DALYs）避免了。 2005年的成本以国际美元（$ Int）表示。>结果：单个最具成本效益的策略因地区而异，但同时执行多项道路安全法的联合干预策略产生的成本最高。给定投资额的健康收益。例如，在所考虑的两个子区域中，限速，酒后驾驶法规和摩托车头盔的使用相结合，可以节省一个DALY，费用为Int1000–3000。>结论现有的道路安全措施不可避免地受到不同道路使用者群体和危险因素在道路交通伤害中潜在分布的约束。预计联合执法策略将成为减轻道路交通伤害负担的最有效方法，因为它们在成本方面可观的协同作用中受益，同时可带来更大的整体健康收益。

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