Automated external defibrillators in long-term care facilities are cost-effective. Prehosp Emerg Care 2000;4(4):314-7
Date
10/25/2000Pubmed ID
11045409DOI
10.1080/10903120090941010Scopus ID
2-s2.0-0033790717 (requires institutional sign-in at Scopus site) 19 CitationsAbstract
OBJECTIVE: To assess the cost per life saved of equipping long-term care facilities (LTCFs) with automated external defibrillators (AEDs).
METHODS: Outcomes for cardiac arrests within LTCFs were retrieved for 1994 to 1997 from a comprehensive out-of-hospital cardiac arrest registry in a mid-sized U.S. city. The total expense for all LTCFs to obtain and maintain AEDs and to educate and maintain staff skill was estimated for a theoretical four-year period. The cost per life saved to the time of hospital discharge was calculated based on an estimated survival rate of 25% of patients found in ventricular fibrillation (VF) with placement of AEDs in LTCFs. A sensitivity analysis that varied survival rates and costs was conducted.
RESULTS: Over four years, there were 160 actual arrests in 43 LTCFs, with a hospital discharge survival rate of 2/160. Twenty of 160 presented to emergency medical services in VF. Training costs for four years were $1,225 per AED. Purchase and maintenance expenses for one AED over four years were $3,941. Placing AEDs in LTCFs would cost $87,837 per life saved if 25% of patients found in VF survived to hospital discharge. Sensitivity analysis using survival rates of 5%, 15%, and 35% established the cost per life saved at $439,184, $146,395, and $62,741, respectively. When costs were calculated at one-half and twice the estimated expense, the cost per life saved was $43,918 and $175,674, respectively.
CONCLUSION: Placing AEDs in LTCFs is cost-effective at $87,837 per life saved, if a hospital discharge survival rate of 25% of patients in VF can be achieved.
Author List
Foutz RA, Sayre MRAuthor
Renee Annette Foutz MD Assistant Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Cost-Benefit AnalysisElectric Countershock
Emergency Medical Services
Heart Arrest
Humans
Inservice Training
Nursing Homes
Ohio
Personnel Staffing and Scheduling
Survival Rate
Value of Life
Ventricular Fibrillation