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J Public Health (Oxf). 2013 Mar;35(1):40-8. doi: 10.1093/pubmed/fds067. Epub 2012 Aug 21.

The cost-effectiveness of mandatory 20 mph zones for the prevention of injuries.

Author information

1
Peninsula Technology Assessment Group, Peninsula Medical School, University of Exeter, Veysey Building, Salmon Pool Lane, Exeter EX2 4SG, UK. jaime.peters@pms.ac.uk

Abstract

BACKGROUND:

Traffic calming and speed limits are major public health strategies for further reducing road injuries, especially for vulnerable pedestrians such as children and the elderly. We conducted a cost-benefit analysis (CBA-favoured by transport economists) alongside a cost-utility analysis (CUA-favoured by health economists) of mandatory 20 mph zones, providing a unique opportunity to compare assumptions and results.

METHODS:

A CUA from the public sector perspective and a CBA from a broader societal perspective. One-way, threshold and probabilistic sensitivity analyses were undertaken.

RESULTS:

In low casualty areas the intervention was not cost-effective regardless of approach (CUA: cost per QALY = £429 800; CBA: net present value = -£25 500). In high casualty areas, the intervention was cost-effective from the CBA (a saving of £90 600), but not from the CUA [cost per quality-adjusted life year (QALY) = £86 500; assuming National Institute for Health and Clinical Excellence's benchmark for approving health technologies].

CONCLUSIONS:

Mandatory 20 mph zones may be cost-effective in high casualty areas when a CBA from a societal perspective is considered. Although CBA may appear, in principle, more appropriate, the quality, age or absence of reliable data for many parameters means that there is a great deal of uncertainty and the results should be interpreted with caution.

PMID:
22915770
DOI:
10.1093/pubmed/fds067
[Indexed for MEDLINE]

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