Journal article
Cost-effectiveness of in-home automated external defibrillators for individuals at increased risk of sudden cardiac death: There’s no place like home?
Journal of general internal medicine : JGIM, Vol.20(3), pp.251-258
03/2005
DOI: 10.1111/j.1525-1497.2005.40247.x
PMCID: PMC1490077
PMID: 15836529
Abstract
BACKGROUND/OBJECTIVE: In-home automated external defibrillators (AEDs) are increasingly recommended as a means for improving survival of cardiac arrests that occur at home. The current study was conducted to explore the relationship between individuals’ risk of cardiac arrest and cost-effectiveness of in-home AED deployment.
DESIGN: Markov decision model employing a societal perspective.
PATIENTS: Four hypothetical cohorts of American adults 60 years of age at progressively greater risk for sudden cardiac death (SCD): 1) all adults (annual probability of SCD 0.4%); 2) adults with multiple SCD risk factors (probability 2%); 3) adults with previous myocardial infarction (probability 4%); and 4) adults with ischemic cardiomyopathy unable to receive an implantable defibrillator (probability 6%).
INTERVENTION: Strategy 1: individuals suffering an in-home cardiac arrest were treated with emergency medical services equipped with AEDs (EMS-D). Strategy 2: individuals suffering an in-home cardiac arrest received initial treatment with an in-home AED, followed by EMS.
RESULTS: Assuming cardiac arrest survival rates of 15% with EMS-D and 30% with AEDs, the cost per quality-adjusted life-year gained (QALY) of providing in-home AEDs to all adults 60 years of age is $216,000. Costs of providing in-home AEDs to adults with multiple risk factors (2% probability of SCD), previous myocardial infarction (4% probability), and ischemic cardiomyopathy (6% probability) are $132,000, $104,000, and $88,000, respectively.
CONCLUSIONS: The cost-effectiveness of in-home AEDs is intimately linked to individuals’ risk of SCD. However, providing in-home AEDs to all adults over age 60 appears relatively expensive.
Details
- Title: Subtitle
- Cost-effectiveness of in-home automated external defibrillators for individuals at increased risk of sudden cardiac death: There’s no place like home?
- Creators
- Peter Cram - Division of General Medicine, Department of Internal Medicine University of Iowa College of Medicine Iowa City IA USASandeep Vijan - Ann Arbor Veterans Affairs Health Services Research and Development Field Program Ann Arbor MI USADavid Katz - Department of Epidemiology University of Iowa College of Public Health Iowa City IA USAA Mark Fendrick - Consortium for Health Outcomes, Innovation, and Cost Effectiveness Studies (CHOICES) University of Michigan School of Medicine Ann Arbor MI USA
- Resource Type
- Journal article
- Publication Details
- Journal of general internal medicine : JGIM, Vol.20(3), pp.251-258
- Publisher
- Springer-Verlag
- DOI
- 10.1111/j.1525-1497.2005.40247.x
- PMID
- 15836529
- PMCID
- PMC1490077
- ISSN
- 0884-8734
- eISSN
- 1525-1497
- Language
- English
- Date published
- 03/2005
- Academic Unit
- Epidemiology; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984094582502771
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