April 7, 1998Circulation
Potential Cost-effectiveness of Public Access Defibrillation in the United States
Key result
Public access defibrillation by lay responders or police had a median incremental cost of $44,000 and $27,200 per additional quality-adjusted life year, respectively, compared to standard EMS.
Why the study?
Is public access defibrillation cost-effective compared to standard EMS for out-of-hospital sudden cardiac arrest?
Population
Out-of-hospital sudden cardiac arrest patients in the United States
Comparison
Emergency medical services supplemented by… vs Standard emergency medical services (EMS) systems
Design
Other
Authors
Discussion
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Member takes
Implication
These ICERs suggest potential cost-effectiveness; leaves open confirmation in randomized trials.
Structured PICO
Is public access defibrillation cost-effective compared to standard EMS for out-of-hospital sudden cardiac arrest?
P
Population
Decision model evaluating the potential cost-effectiveness of public access defibrillation for out-of-hospital sudden cardiac arrest in the United States.
I
Intervention
Emergency medical services (EMS) supplemented by public access defibrillation (PAD) by lay responders or police
C
Comparator
Standard emergency medical services (EMS) systems
O
Outcome
Incremental cost per additional quality-adjusted life year (QALY)
Public access defibrillation by lay responders or police appears to be economically attractive for out-of-hospital sudden cardiac arrest, supporting the need for randomized controlled trials.
Limitations
- Results were sensitive to changes in the cost and relative survival benefit of PAD
Cite This Study
Nichol et al. (1998) studied out-of-hospital sudden cardiac arrest. Public access defibrillation (PAD) vs. Standard emergency medical services (EMS) was evaluated on Incremental cost per additional quality-adjusted life year. Public access defibrillation by lay responders or police had a median incremental cost of $44,000 and $27,200 per additional quality-adjusted life year, respectively, compared to standard EMS.