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Using Cost-Effectiveness Analysis to Prioritize Spending on Traffic Safety

by Liisa Ecola, Benjamin Saul Batorsky, Jeanne S. Ringel

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Research Questions

  1. What are the effects of implementing the most cost-effective interventions?
  2. What is the most cost-effective way to allocate an increase in funding for interventions?
  3. Given this set of interventions, what is the most cost-effective way to reduce drunk driving?

This report examines how traffic safety funding could be spent to reduce motor vehicle crash–related injuries and deaths. Specifically, it assesses three issues: the most cost-effective interventions at the national and state levels, whether to allocate incremental funding increases to all states or spend the funds in targeted states, and how best to allocate funds that target drunk driving. The authors base the analysis of the cost-effectiveness of various interventions across the states, as well as the comparisons of different funding scenarios, on the data and analysis of an interactive online tool, the Motor Vehicle Prioritizing Interventions and Cost Calculator for States (MV PICCS). RAND Corporation researchers developed the tool for the Centers for Disease Control and Prevention's National Center for Injury Prevention and Control, which hosts the tool; additional funding from the Robert Wood Johnson Foundation expanded the tool to include two more interventions and supported these analyses.

Key Findings

Implementing the Most Cost-Effective Interventions Reduces Injury and Death

  • For the nation overall, implementing the three most cost-effective interventions in all states where they are not currently in place would prevent 1,219 fatalities and cost approximately $55 million.
  • Implementing the most cost-effective intervention for each state instead would prevent 928 fatalities and cost about $60 million.
  • The national approach is more cost-effective but does not spread the reduction in fatalities across all states.

The Most Cost-Effective Way to Allocate National Funds Is to Target the Funding to the Most Cost-Effective Interventions Regardless of State

  • When targeted to the most cost-effective interventions, an additional 10 percent of nationally available funds would prevent 1,320 fatalities and use the majority of the available funding ($57.8 million).
  • Giving each state instead a 10-percent increase in funding prevents 660 fatalities and uses only about half the available funds.

The Most Cost-Effective Way to Reduce Drunk Driving--Related Deaths and Injuries Is to Target Implementation of the Most Cost-Effective Interventions Regardless of State

  • Implementing the ten most cost-effective state--intervention combinations would cost $2.1 million and would prevent 170 fatalities.

Strategies That Focus on Identifying and Implementing the Most Cost-Effective Interventions, Regardless of Location, Make the Most Effective Use of Limited Traffic Safety Dollars

  • These strategies do not spread the benefits of reduced injuries and deaths across all states. Strategies that seek to make changes in each state might be seen as more equitable but lead to a less effective use of the limited resources.

Recommendation

  • In deciding how to allocate funds targeting traffic safety, policymakers must determine the appropriate trade-off between cost-effectiveness and equity among states.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Approach

  • Chapter Three

    What Are the Effects of Implementing the Most Cost-Effective Interventions?

  • Chapter Four

    What Is the Most Cost-Effective Way to Allocate an Increase in Funding for Interventions?

  • Chapter Five

    Given This Set of Interventions, What Is the Most Cost-Effective Way to Reduce Drunk Driving?

  • Chapter Six

    Conclusion

  • Appendix

    Reference Tables

The research reported here was conducted jointly in RAND Health and in the Transportation, Space, and Technology Program, a part of RAND Justice, Infrastructure, and Environment.

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