title: Smoke alarm giveaway and installation programs: an economic evaluation.
abstract: BACKGROUND
  The burden of residential fire injury and death is substantial. Targeted smoke alarm giveaway and installation programs are popular interventions used to reduce residential fire mortality and morbidity.
  
  
  OBJECTIVE
  To evaluate the cost effectiveness and cost benefit of implementing a giveaway or installation program in a small hypothetic community with a high risk of fire death and injury through a decision-analysis model.
  
  
  METHODS
  Model inputs included program costs; program effectiveness (life-years and quality-adjusted life-years saved); and monetized program benefits (medical cost, productivity, property loss and quality-of-life losses averted) and were identified through structured reviews of existing literature (done in 2011) and supplemented by expert opinion. Future costs and effectiveness were discounted at a rate of 3% per year. All costs were expressed in 2011 U.S. dollars.
  
  
  RESULTS
  Cost-effectiveness analysis (CEA) resulted in an average cost-effectiveness ratio (ACER) of $51,404 per quality-adjusted life-years (QALYs) saved and $45,630 per QALY for the giveaway and installation programs, respectively. Cost-benefit analysis (CBA) showed that both programs were associated with a positive net benefit with a benefit-cost ratio of 2.1 and 2.3, respectively. Smoke alarm functional rate, baseline prevalence of functional alarms, and baseline home fire death rate were among the most influential factors for the CEA and CBA results.
  
  
  CONCLUSIONS
  Both giveaway and installation programs have an average cost-effectiveness ratio similar to or lower than the median cost-effectiveness ratio reported for other interventions to reduce fatal injuries in homes. Although more effort is required, installation programs result in lower cost per outcome achieved compared with giveaways.
authors.affiliation: National Center for Injury Prevention and Control, CDC, 4770 Buford Hwy. NE, Atlanta GA 30341, USA.
authors.forename: Ying
authors.initials: Y
authors.lastname: Liu
authors.forename: Karin A
authors.initials: KA
authors.lastname: Mack
authors.forename: Shane T
authors.initials: ST
authors.lastname: Diekman
mesh_terms: D000056:Accident Prevention / Q000191:economics / Q000379:methods*; D000061:Accidents, Home / Q000191:economics / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D005390:Fires / Q000191:economics / Q000517:prevention & control*; D006801:Humans; D016730:Program Development; D011482:Protective Devices / Q000191:economics*; D019057:Quality-Adjusted Life Years; D014481:United States