TY - JOUR
T1 - Cost-Effectiveness of Lay Responder Defibrillation for Out-of-Hospital Cardiac Arrest
AU - Nichol, Graham
AU - Huszti, Ella
AU - Birnbaum, Alice
AU - Mahoney, Brian
AU - Weisfeldt, Myron
AU - Travers, Andrew
AU - Christenson, Jim
AU - Kuntz, Karen
N1 - Funding Information:
Contract N01-HC-95177 from the National Heart, Lung, and Blood Institute, Bethesda, MD, with additional support from the American Heart Association, Dallas, TX; Guidant Corporation, Indianapolis, IN; Medtronic, Inc., Minneapolis, MN; Cardiac Science/Survivalink, Inc., Minneapolis, MN; Medtronic ERS, Redmond, WA; Philips Medical Systems, Cardiac Resuscitation, Seattle, WA; and Laerdal Medical Corporation, Wappinger Falls, NY.
PY - 2009/8
Y1 - 2009/8
N2 - Study objective: Our objective is to evaluate the incremental cost-effectiveness of use of cardiopulmonary resuscitation (CPR) and automated external defibrillators (AEDs) by lay responders (CPR+AED) versus CPR only for cardiac arrest during a multicenter randomized trial. Methods: This was a prospective trial from July 2000 to September 2003 that randomly assigned 993 community units (eg, office buildings, public areas) in 24 sites to an emergency response system, using lay volunteers trained in CPR only or CPR+AED. Cost and quality of life data were collected with effectiveness data. The primary analysis evaluated the incremental cost-effectiveness of defibrillator use in public locations by using Markov modeling. Results: CPR only had 14 survivors to discharge and CPR+AED had 29. CPR only had a mean of 0.58 (95% confidence interval [CI] 0.28 to 0.88) quality-adjusted life-years and a mean $42,400 (95% CI $22,100 to $62,600) costs. CPR+AED had mean 1.14 (95% CI 0.44 to 1.83) quality-adjusted life-years, mean $68,400 (95% CI $28,300 to $108,400) costs, and a long-term cost of mean $46,700 (95% CI $23,100 to $68,600) per quality-adjusted life-year. Results were sensitive to the effectiveness of the intervention, time horizon, location of arrest, and other factors. Conclusion: Training and equipping lay volunteers to defibrillate in public places may have an incremental cost-effectiveness that is similar to that of other common health interventions.
AB - Study objective: Our objective is to evaluate the incremental cost-effectiveness of use of cardiopulmonary resuscitation (CPR) and automated external defibrillators (AEDs) by lay responders (CPR+AED) versus CPR only for cardiac arrest during a multicenter randomized trial. Methods: This was a prospective trial from July 2000 to September 2003 that randomly assigned 993 community units (eg, office buildings, public areas) in 24 sites to an emergency response system, using lay volunteers trained in CPR only or CPR+AED. Cost and quality of life data were collected with effectiveness data. The primary analysis evaluated the incremental cost-effectiveness of defibrillator use in public locations by using Markov modeling. Results: CPR only had 14 survivors to discharge and CPR+AED had 29. CPR only had a mean of 0.58 (95% confidence interval [CI] 0.28 to 0.88) quality-adjusted life-years and a mean $42,400 (95% CI $22,100 to $62,600) costs. CPR+AED had mean 1.14 (95% CI 0.44 to 1.83) quality-adjusted life-years, mean $68,400 (95% CI $28,300 to $108,400) costs, and a long-term cost of mean $46,700 (95% CI $23,100 to $68,600) per quality-adjusted life-year. Results were sensitive to the effectiveness of the intervention, time horizon, location of arrest, and other factors. Conclusion: Training and equipping lay volunteers to defibrillate in public places may have an incremental cost-effectiveness that is similar to that of other common health interventions.
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U2 - 10.1016/j.annemergmed.2009.01.021
DO - 10.1016/j.annemergmed.2009.01.021
M3 - Article
C2 - 19321228
AN - SCOPUS:67650395603
SN - 0196-0644
VL - 54
SP - 226-235.e2
JO - Annals of emergency medicine
JF - Annals of emergency medicine
IS - 2
ER -