Cost-effectiveness of defibrillation by emergency medical technicians

Ornato, Joseph P.; Craren, Edward J.; Gonzalez, Edgar R.; Garnett, A Randolph; McCLUNG, Barbara; Newman, Mary M.

doi:10.1016/0735-6757(88)90045-9

Cited by 17 publications

(3 citation statements)

References 14 publications

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“…53,187,194,195 This data establishes the substantial survival benefits and attractive cost-effectiveness of a well-designed and well-implemented PAD program.…”

Section: Effectiveness Of Pad Programsmentioning

confidence: 58%

Part 4: The Automated External Defibrillator : Key Link in the Chain of Survival

2000

Circulation

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“…53,187,194,195 This data establishes the substantial survival benefits and attractive cost-effectiveness of a well-designed and well-implemented PAD program.…”

Section: Effectiveness Of Pad Programsmentioning

confidence: 58%

Part 4: The Automated External Defibrillator : Key Link in the Chain of Survival

2000

Circulation

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“…The cost, including training and equipment, was estimated by the Ambulance service at $125,000, with the benefit over the initial three years of 14 lives saved. This equated to approximately $9,000 per life, a cost which compares favourably with other life saving interventions in the field of cardiovascular disease 14,15 . Further training of ambulance officers in this area also improves assessment and management of all emergency transports.…”

Section: Discussionmentioning

confidence: 99%

Prehospital defibrillation in Geelong

Jackson

Cameron

1993

Emergency Medicine

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Introduction: In 1988, a defibrillation/CPR protocol was phased in over 12 months for the management of ventricular fibrillation (VF) by ambulance officers, in the Geelong region of Victoria. This study reviews the three years following its inception. Study objective: To determine the success of this intervention in terms of survivors to hospital discharge, and compare this to the previous Australian and international literature. Methods: A retrospective case analysis of the initial three years from June 1988‐June 1991. Ambulance case sheets and hospital records were studied for all patients where the protocol was exercised. Results: Of 125 cases studied, 46 were excluded. Fourteen (18%) of the 79 patients included survived to hospital discharge. Conclusion: The results compare favourably with previously published reports, and reaffirm early defibrillation as the key intervention in the management of VF.

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“…Studies focusing on pre-hospital interventions compared various attributes of EMS systems capable of resuscitating patients against those without such a capability 19 as well as the value of prehospital critical care. 20 Frequently this focused on comparing the deployment of various cadres of support providers including specially trained emergency medical technicians, [21][22][23] police personnel, 24 and re stations 25 , to the current standard of only emergency physicians. The effect of reducing ambulance response time was addressed in two studies.…”

Section: Intervention and Comparatormentioning

confidence: 99%

A Systematic Review of Cost-Effectiveness of Treating Out of Hospital Cardiac Arrest: Implications for Resource-limited Health Systems

Werner,

Hirner,

Offorjebe

et al. 2024

Preprint

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Background Out-of-hospital cardiac arrest (OHCA) is a prevalent condition with high mortality and poor outcomes even in settings where extensive emergency care resources are available. Interventions to address OHCA have had limited success, with survival rates below 10% in national samples of high-income countries. In resource-limited settings, where scarcity requires careful priority setting, more data is needed to determine the optimal allocation of resources. Objective To establish the cost-effectiveness of OHCA care and assess the affordability of interventions across income settings. Methods The authors conducted a systematic review of economic evaluations on interventions to address OHCA. Included studies were (1) economic evaluations (beyond a simple costing exercise); and (2) assessed an intervention in the chain of survival for OHCA. Article quality was assessed using the CHEERs checklist and data summarised. Findings were reported by major themes identified by the reviewers. Based upon the results of the cost-effectiveness analyses we then conduct an analysis for the progressive realization of the OHCA chain of survival from the perspective of decision-makers facing resource constraints. Results 468 unique articles were screened, and 46 articles were included for final data abstraction. Studies predominantly used a healthcare sector perspective, modeled for all patients experiencing non-traumatic cardiac OHCA, were based in the US, and presented results in US Dollars. No studies reported results or used model inputs from low-income settings. Progressive realization of the chain of survival could likely begin with investments in TOR protocols, professional prehospital defibrillator use, and CPR training followed by distribution of AEDs in high-density public locations. Finally, other interventions such as indiscriminate defibrillator placement or adrenaline use, would be the lowest priority for early investment. Conclusion Our review found no high-quality evidence on the cost-effectiveness of treating OHCA in low-resource settings. Existing evidence can be utilized to develop a roadmap for the development of a cost-effective approach to OHCA care, however further economic evaluations using context-specific data are crucial to accurately inform prioritization of scarce resources within emergency care in these settings.

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Cost-effectiveness of defibrillation by emergency medical technicians

Cited by 17 publications

References 14 publications

Part 4: The Automated External Defibrillator : Key Link in the Chain of Survival

Part 4: The Automated External Defibrillator : Key Link in the Chain of Survival

Prehospital defibrillation in Geelong

A Systematic Review of Cost-Effectiveness of Treating Out of Hospital Cardiac Arrest: Implications for Resource-limited Health Systems

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