Cost-effectiveness analysis of potential improvements to emergency medical services for victims of out-of-hospital cardiac arrest.
To measure the incremental cost-effectiveness of various improvements to emergency medical services (EMS) systems aimed at increasing survival after out-of-hospital cardiac arrest.
We performed cost-effectiveness analysis based on (1) metaanalysis of effectiveness of the various EMS systems, (2) costing of each component of EMS systems, (3) modeling of the relationship between the proportion of cardiac arrest victims who receive CPR and the proportion of individuals trained, (4) modeling of the relationship between response time interval and the characteristics of the EMS system, (5) measurement of quality of life, and (6) decision analysis to combine the results of the first five components.
The incremental cost-effectiveness ratio for a 48-second improvement in mean response time in a one-tier EMS system yielded by the addition of more EMS providers was $368,000 per quality-adjusted life year (QALY).
For improved response time in a two-tier EMS system by the addition of more basic life support (BLS)/BLS-defibrillator (BLS-D) providers to the first tier, the ratio was $53,000 per QALY with pump vehicles or $159,000 per QALY with ambulances.
Change from a one-tier EMS to a two-tier EMS system by the addition of initial BLS/BLS-D providers in pump vehicles as the first tier was associated with a cost per QALY of $40,000. (...)
Mots-clés Pascal : Arrêt cardiocirculatoire, Coût spécifique, Efficacité, Survie, Soin, Urgence, Epidémiologie, Homme, Appareil circulatoire pathologie
Mots-clés Pascal anglais : Cardiocirculatory arrest, Specific cost, Efficiency, Survival, Care, Emergency, Epidemiology, Human, Cardiovascular disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0308845
Code Inist : 002B30A01C. Création : 10/04/1997.