School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Centre for Societal Risk Research, Karlstad University, Karlstad, Sweden.
Inj Prev. 2022 Apr;28(2):125-130. doi: 10.1136/injuryprev-2021-044203. Epub 2021 Jun 28.
Slipping on snow or ice poses a significant health risk among older adults in Sweden. To combat this problem, about 80 Swedish municipalities have distributed ice cleats to older citizens (65+ years old) over the last decade. This paper details a cost-benefit analysis of such programmes.
We developed a decision-analytical model to estimate the costs and benefits of ice cleat programmes in Swedish municipalities compared with a business-as-usual scenario. The modelled benefits of the programme were based on effect estimates from previous research, data from population and healthcare registers and a survey of attitudes to and actual ice cleat use. The modelled costs of the programme were based on resource use data collected from 34 municipalities with existing ice cleat programmes. We assessed heterogeneity in the potential impact and benefit-to-cost ratios across all Swedish municipalities as a function of the average number of days with snow cover per year. Uncertainty in the cost-benefit results was assessed using deterministic and probabilistic sensitivity analyses.
The average benefit-to-cost ratio was 87, ranging from about 40 in low-risk municipalities to 140 in high-risk municipalities, implying that the potential benefits of ice cleat programmes greatly outweigh their costs. Probabilistic and deterministic sensitivity analyses support the robustness of this conclusion to parameter uncertainty and large changes in assumptions about the magnitude of the impact on ice cleat use and injuries.
The benefits of distributing ice cleats to older adults appear to outweigh the costs from a Swedish societal perspective.
在瑞典，老年人在雪地或冰面上滑倒会对他们的健康造成严重威胁。为了解决这个问题，在过去十年中，大约 80 个瑞典市政当局向老年公民（65 岁以上）分发了防滑钉。本文详细介绍了此类计划的成本效益分析。
我们开发了一个决策分析模型，以估计与常规情况相比，瑞典市政当局的防滑钉计划的成本和效益。该计划的模型效益基于先前研究的效果估计、人口和医疗保健登记数据以及对防滑钉使用的态度和实际使用情况的调查。该计划的模型成本基于从 34 个具有现有防滑钉计划的市政当局收集的资源使用数据。我们评估了所有瑞典市政当局的潜在影响和效益成本比的异质性，作为每年积雪天数的函数。使用确定性和概率敏感性分析评估成本效益结果的不确定性。
平均效益成本比为 87，范围从低风险市政当局的约 40 到高风险市政当局的 140，这意味着防滑钉计划的潜在效益大大超过了其成本。概率和确定性敏感性分析支持这一结论对参数不确定性和对防滑钉使用和伤害影响程度的假设的重大变化具有稳健性。
从瑞典社会的角度来看，向老年人分发防滑钉的好处似乎超过了成本。
