Preventing deaths and injuries from house fires: a cost-benefit analysis of a community-based smoke alarm installation programme.
Operation Installation (OI), a community-based smoke alarm installation programme in Dallas, Texas, targets houses in high-risk urban census tracts. Residents of houses that received OI installation (or programme houses) had 68% fewer medically treated house fire injuries (non-fatal and fatal) compared with residents of non-programme houses over an average of 5.2 years of follow-up during an effectiveness evaluation conducted from 2001 to 2011.



To estimate the cost-benefit of OI.



A mathematical model incorporated programme cost and effectiveness data as directly observed in OI. The estimated cost per smoke alarm installed was based on a retrospective analysis of OI expenditures from administrative records, 2006-2011. Injury incidence assumptions for a population that had the OI programme compared with the same population without the OI programme was based on the previous OI effectiveness study, 2001-2011. Unit costs for medical care and lost productivity associated with fire injuries were from a national public database.



From a combined payers' perspective limited to direct programme and medical costs, the estimated incremental cost per fire injury averted through the OI installation programme was $128,800 (2013 US$). When a conservative estimate of lost productivity among victims was included, the incremental cost per fire injury averted was negative, suggesting long-term cost savings from the programme. The OI programme from 2001 to 2011 resulted in an estimated net savings of $3.8 million, or a $3.21 return on investment for every dollar spent on the programme using a societal cost perspective.



Community smoke alarm installation programmes could be cost-beneficial in high-fire-risk neighbourhoods.
Injury Prevention Center of Greater Dallas, Dallas, Texas, USA.
Merissa A
MA
Yellman
National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.
Cora
0000-0001-7955-0977
C
Peterson
Injury Prevention Center of Greater Dallas, Dallas, Texas, USA.
Mary A
MA
McCoy
Injury Prevention Center of Greater Dallas, Dallas, Texas, USA.
Shelli
S
Stephens-Stidham
Dallas Fire Rescue Department, Inspection and Life Safety Education Division, Dallas, Texas, USA.
Emily
E
Caton
The Southwestern Institute of Forensic Sciences, Office of the Medical Examiner, Dallas, Texas, USA.
Jeffrey J
JJ
Barnard
Dallas Fire Rescue Department, Inspection and Life Safety Education Division, Dallas, Texas, USA.
Ted O
TO
Padgett
National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA.
Curtis
C
Florence
Injury Prevention Center of Greater Dallas, Dallas, Texas, USA.
Gregory R
GR
Istre
D000056:Accident Prevention / Q000191:economics* / Q000295:instrumentation*; D000061:Accidents, Home / Q000191:economics / Q000517:prevention & control*; D018672:Community Health Planning; D003362:Cost-Benefit Analysis; D005390:Fires / Q000191:economics* / Q000517:prevention & control* / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D006798:Housing; D006801:Humans; D008962:Models, Theoretical; D016730:Program Development; D015397:Program Evaluation; D011482:Protective Devices / Q000191:economics*; D013781:Texas; D014505:Urban Population