Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
The European Journal of Health Economics
Published in: The European Journal of Health Economics 6/2012

01-12-2012 | Original Paper

Favourable cost-benefit in an early defibrillation programme using dual dispatch of ambulance and fire services in out-of-hospital cardiac arrest

Authors: Björn Sund, Leif Svensson, Mårten Rosenqvist, Jacob Hollenberg

Published in: The European Journal of Health Economics | Issue 6/2012

Login to get access

Abstract

Aims

Out-of-hospital cardiac arrest is fatal without treatment, and time to defibrillation is an extremely important factor in relation to survival. We performed a cost-benefit analysis of dual dispatch defibrillation by ambulance and fire services in the County of Stockholm, Sweden.

Methods and results

A cost-benefit analysis was performed to evaluate the effects of dual dispatch defibrillation. The increased survival rates were estimated from a real-world implemented intervention, and the monetary value of a life (€ 2.2 million) was applied to this benefit by using results from a recent stated-preference study. The estimated costs include defibrillators (including expendables/maintenance), training, hospitalisation/health care, fire service call-outs, overhead resources and the dispatch centre. The estimated number of additional saved lives was 16 per year, yielding a benefit-cost ratio of 36. The cost per quality-adjusted life years (QALY) was estimated to be € 13,000, and the cost per saved life was € 60,000.

Conclusions

The intervention of dual dispatch defibrillation by ambulance and fire services in the County of Stockholm had positive economic effects. For the cost-benefit analysis, the return on investment was high and the cost-effectiveness showed levels below the threshold value for economic efficiency used in Sweden. The cost-utility analysis categorises the cost per QALY as medium.
Appendix
Available only for authorised users
Literature
1.
Salomaa, V., Ketonen, M., Koukkunen, H., Immonen-Räihä, P., Jerkkola, T., et al.: Decline in out-of-hospital coronary heart disease deaths has contributed the main part to the overall decline in coronary heart disease mortality rates among persons 35 to 64 years of age in Finland. The FINAMI study. Circulation 108, 691–696 (2003)PubMedCrossRef
2.
Engdahl, J., Holmberg, M., Karlson, B.W., Luepker, R., Herlitz, J.: The epidemiology of out-of-hospital’sudden’ cardiac arrest. Resuscitation 52, 235–245 (2002)PubMedCrossRef
3.
Cummings, R.O., Ornato, J.P., Thies, W.H., Pepe, P.E.: Improving survival from sudden cardiac arrest: the ‘chain-of-survival’ concept. A statement for health professionals from the Advanced Cardiac Life Support Subcommittee and the Emergency Cardiac Care Committee, American Heart Association. Circulation 83, 1832–1847 (1991)CrossRef
4.
Hollenberg, J., Lindqvist, J., Ringh, M., Engdahl, J., Bohm, K., et al.: An evaluation of post-resuscitation care as a possible explanation of a difference in survival after out-of-hospital cardiac arrest. Resuscitation 74, 242–252 (2007)PubMedCrossRef
5.
Forrer, C.S., Swor, R.A., Jackson, R.E., Pascual, R.G., Compton, S., McEachin, C.: Estimated cost effectiveness of a police automated external defibrillator program in a suburban community: 7 years experience. Resuscitation 52, 23–29 (2002)PubMedCrossRef
6.
Nichol, G., Valenzuela, T., Roe, D., Clark, L., Huszti, E., Wells, G.A.: Cost effectiveness of defibrillation by targeted responders in public settings. Circulation 108, 697–703 (2003)PubMedCrossRef
7.
Walker, A., Sirel, J.M., Marsden, A.K., Cobbe, S.M., Pell, J.P.: Cost effectiveness and cost utility model of public place defibrillators in improving survival after prehospital cardiopulmonary arrest. BMJ 327; 6 Dec 2003
8.
van Alem, A.P., Dijkgraaf, M.G.W., Tijssen, J.G.P., Koster, R.W.: Health system costs of out-of-hospital cardiac arrest in relation to time to shock. Circulation 110, 1967–1973 (2004)PubMedCrossRef
9.
Næss, A., Steen, P.A.: Long term survival and costs per life year gained after out-of-hospital cardiac arrest. Resuscitation 60, 57–64 (2004)PubMedCrossRef
10.
Groeneveld, P.W., Owens, D.K.: Cost-effectiveness of training unselected laypersons in cardiopulmonary resuscitation and defibrillation. Am. J. Med. 118, 58–67 (2005)PubMedCrossRef
11.
Lerner, E.B., Maio, R.F., Garrison, H.G., Spaite, D.W., Nichol, G.: Economic value of out-of-hospital emergency care: A structured literature review. Ann. Emerg. Med. 47(6), 515–524 (2006)PubMedCrossRef
12.
Sund, B.: The Value of a Statistical Life for Out-of-Hospital Cardiac Arrest Victims. The Swedish Business School at Örebro University. Working Paper 2010:4
13.
14.
15.
Hollenberg, J., Riva, G., Bohm, K., Nordberg, P., Larsen, R., et al.: Dual dispatch early defibrillation in out-of-hospital cardiac arrest: the SALSA-pilot. Eur. Heart J. 30, 1781–1789 (2009)PubMedCrossRef
16.
Rauner, M.S., Bajmoszy, N.: How many AEDs in which region? An economic decision model for the Austrian Red Cross. Eur. J. Oper. Res. 150, 3–18 (2003)CrossRef
17.
Eisenburger, P., List, M., Schörkhuber, W., Walker, R., Sterz, F., Laggner, A.N.: Long-term cardiac arrest survivors of the Vienna emergency medical service. Resuscitation 38, 137–143 (1998)PubMedCrossRef
18.
Nichol, G., Stiell, I.G., Herbert, P., Wells, G.A., Vandemheen, K., Laupacis, A.: What is the quality of life for survivors of cardiac arrest? A prospective study. Acad. Emerg. Med. 6(2), 95–102 (1999)PubMedCrossRef
19.
Stiell, I., Nichol, G., Wells, G., De Maio, V., Nesbitt, L., et al.: Health-related quality of life is better for cardiac arrest survivors who received citizen cardiopulmonary resuscitation. Circulation 108, 1939–1944 (2003)PubMedCrossRef
20.
Nichol, G., Wells, G.A., Kuntz, K., Feeny, D., Longstreth, W., et al.: Methodological design for economic evaluation in Public Access Defibrillation (PAD) trial. Am. Heart J. 150(2), 202–208 (2005)PubMedCrossRef
21.
Lerner, B., Nichol, G., Spaite, D.W., Garrison, H.G., Maio, R.F.: A comprehensive framework for determining the cost of an emergency medical services system. Ann. Emerg. Med. 49(3), 304–313 (2007)PubMedCrossRef
22.
Kågebro, E.: Automatiska brandlarm. Hur bör räddningstjänsten agera? Räddningsverket; beställningsnummer (in Swedish) P21-476/07 (2007)
23.
24.
Ebell, M.H., Kruse, J.A.: A proposed model for the cost of cardiopulmonary resuscitation. Med. Care 32(6), 640–649 (1994)PubMedCrossRef
25.
Sund, B.: Insats av räddningstjänstpersonal vid hjärtstopp—en kostnadsnyttoanalys (in Swedish). Räddningsverket, beställningsnummer P21-445/04 (2004)
26.
Caro, J.J., Ward, A., Deniz, H.B., O’Brien, J.A., Ehreth, J.L.: Cost-benefit analysis of preventing sudden cardiac deaths with an implantable cardioverter defibrillator versus amiodarone. Value Health 10(1), 13–22 (2007)PubMedCrossRef
27.
28.
Persson, U., Ramsberg, J.: Hälsoekonomiska utvärderingar har stor betydelse för LFVs beslut (in Swedish). Läkartidningen 104(42), 3046–3050 (2007)PubMed
29.
Metadata
Title
Favourable cost-benefit in an early defibrillation programme using dual dispatch of ambulance and fire services in out-of-hospital cardiac arrest
Authors
Björn Sund
Leif Svensson
Mårten Rosenqvist
Jacob Hollenberg
Publication date
01-12-2012
Publisher
Springer-Verlag
Published in
The European Journal of Health Economics / Issue 6/2012
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-011-0338-7

Other articles of this Issue 6/2012

The European Journal of Health Economics 6/2012 Go to the issue

Original Paper

Economic evaluation of pay-for-performance in health care: a systematic review

Original Paper

Cost effectiveness of golimumab for the treatment of active psoriatic arthritis

Original Paper

Epilepsy in Sweden: health care costs and loss of productivity—a register-based approach

Original Paper

The cost-effectiveness of cash versus lottery incentives for a web-based, stated-preference community survey

Original Paper

Patients whose GP knows complementary medicine tend to have lower costs and live longer

Editorial

The Grossman model after 40 years