OBJECTIVE There are few cost-effectiveness analyses that model alcohol outlet zoning policies. This study determines the potential decreases in homicides, disability-adjusted life years (DALYs), and victim and criminal justice costs associated with four policy options that would reduce the alcohol outlet access in Baltimore. METHOD This cost-effectiveness analysis used associations between on-premise (incidence rate ratio [IRR] = 1.41), off-premise (IRR = 1.76), and combined on- and off-premise outlet density (IRR = 1.07) and homicide in Baltimore. We determined the potential change in the level of homicide that could occur with changes in the density of alcohol outlets, assuming that 50% of the association was causal. RESULTS Reducing alcohol outlet density in Baltimore City by one quintile was associated with decreases of 51 homicides per year, $63.7 million, and 764 DALYs. Removing liquor stores in residential zones was associated with 22 fewer homicides, which would cost $27.5 million and lead to 391 DALYs. Removing bars/taverns operating as liquor stores was associated with a decrease of one homicide, $1.2 million, and 17 DALYs. Removing both the liquor stores in residential zones and the bars/taverns operating as liquor stores was associated with 23 fewer homicides, which translated to $28.7 million and 409 DALYs. CONCLUSIONS For preventing homicides, the strategy of removing liquor stores in residential zones was preferred because it was associated with substantial reductions in homicides without closing unacceptably high numbers of outlets. It is possible that policies that close the bars/taverns operating as liquor stores would be associated with decreases in other types of violent crime.

中文翻译：

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减少马里兰州巴尔的摩市酒精出口的暴力预防潜力

目的很少有成本效益分析可用于模拟酒精出口分区政策。这项研究确定了杀人案，残疾调整生命年（DALYs）以及与减少巴尔的摩酒精出口的四种政策选择相关的受害者和刑事司法费用的潜在减少。方法该成本效益分析使用了内部场所（发生率比率[IRR] = 1.41），外部场所（IRR = 1.76）以及内部和外部场所出口密度（IRR = 1.07）与杀人罪之间的关联。巴尔的摩。我们确定了可能伴随着酒精出口密度的变化而发生的凶杀水平的潜在变化，假设这种关联的50％是因果关系。结果巴尔的摩市的酒精出口密度降低了五分之一，这与每年减少51种凶杀案有关，6,370万美元，764个DALY。拆除居民区的酒类商店可以减少22种凶杀案，这将花费2750万美元，并导致391名DALY。拆除作为酒类商店的酒吧/小酒馆与减少一桩凶杀案，120万美元和17 DALYs有关。取消居住区的酒类商店和作为酒类商店的酒吧/小酒馆所涉及的凶杀案减少了23种，这意味着凶杀案减少了2,870万美元，杀伤人员年数减少了409个。结论为了防止凶杀，首选在居民区中去除酒类的策略，因为这与凶杀的大量减少相关，而没有关闭大量的出口。