摘要：Although assessing the costs of an intervention to prevent child maltreatment is straightforward, placing a monetary value on benefits is challenging. Respondents participating in a statewide random-digit-dialed survey were asked how much they would be willing to pay to prevent a death caused by child maltreatment. Our results suggested that society may value preventing a death from child maltreatment at $15 million. If a child maltreatment intervention is effective enough to save even 1 life, then in many cases, its benefits will outweigh its costs. Child maltreatment is a serious public health problem affecting at least 1 of 5 children during their lifetimes. 1 In 2008, approximately 1740 children in the United States died from maltreatment. 2 Evidence-based interventions designed to prevent maltreatment and reduce its consequences are emerging 3 ; however, to move policy development forward, information is needed to estimate the returns that investments in these interventions will provide to society. Benefit-cost analysis, which compares an intervention's costs with that intervention's benefits, both measured in monetary units, is an approach to estimate returns on investment. 4 Although assessing the costs to implement an intervention is relatively straightforward, 5 the challenge is estimating a monetary value for potential benefits of these interventions, particularly when the benefits include saving lives. One approach is the human capital method, which relies on future wage rates to assess the value of life as lost productivity to society. 6 – 8 Corso et al. 9 used this method and recently estimated that per-person productivity losses and medical costs for violent deaths experienced by children aged 0 to 4 years was approximately $1 million (in 2000 US$). Although the human capital method captures most of the tangible benefits associated with death resulting from child maltreatment, it does not capture any intangible benefits, such as the pain, suffering, and grief experienced by a community when a child dies, which may be at least as important to taxpayers. 10 Contingent valuation analysis provides another method for valuing societal benefits of preventing a death, of which one approach is asking members of society how much they would be willing to pay to reduce a fatality risk. 11 – 13 We estimated an alternative measure of the benefits of preventing a death associated with child maltreatment by asking survey respondents their willingness to pay for small reductions in the risk of child maltreatment mortality to estimate the value of a life saved from child maltreatment.
