The 130th Annual Meeting of APHA

Abstract #49231

Ted R. Miller, PhD, Eduard Zaloshnja, PhD, and Monique A. Sheppard, PhD. Children's Safety Network, Economics and Insurance Resource Center, Pacific Institute for Research and Evaluation, Calverton Office Park, 11710 Beltsville Drive, Suite 300, Calverton, MD 20705-3102, 301-755-2727, miller@pire.org

Background. This paper presents the first benefit-cost estimate for child seats in the era of airbags and managed care. It provides the first estimate of the impact of misuse reduction efforts on crash outcomes and analyzes return on investment in these efforts. Methods: We separately analyzed 1984-86 and 1993-98 data on passenger vehicle occupants ages 0-4. The data were fatality censuses plus a national probability sample describing restraint use and injury details of towaway crash survivors. We merged published crash costs onto the files used. By seating position and restraint use, log-linear regressions predicted cost of injury. The regressions directly measured the cost impacts of shifting children into child seats and from front to rear. The value of misuse reduction was computed from the benefit-cost ratios that would have been observed in each time period given 1999 restraint use and seating positions. This difference is strictly due to greater seat effectiveness. Intervention costs were costed through interviews on resources used. Results: Misuse checkpoints increased child seat effectiveness by 21%. The estimated benefit-cost ratio for 1984-86 was 36, quite close to a published estimate of 34. In combination, child seat distribution programs and misuse checkpoints currently have a benefit-cost ratio of 50.7 (with $45 seats). Child seats currently save $10.2 billion annually. Both child seat distribution and misuse reduction saved medical expenses exceeding their costs. From Medicaid’s perspective, providing a child seat to every beneficiary ages 0-4 would save medical costs exceeding what Medicaid paid for the seats.

Learning Objectives: At the conclusion of this session, participants will be able to

• Describe the effectiveness and cost-effectiveness of child safety seats and of programs to reduce their misuse.
• Advocate for Medicaid coverage of child safety seats and state funding of misuse reduction checkpoints.

Keywords: Motor Vehicles, Medicaid

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.