Potential cost-effectiveness of public access defibrillation in the United States.
Background-Approximately 360 000 Americans experience sudden cardiac arrest each year ; current treatments are expensive and not very effective.
Public access defibrillation (PAD) is a novel treatment for out-of-hospital sudden cardiac arrest that refers to use of automated external defibrillators by the lay public or by nonmedical personnel such as police.
A clinical trial has been proposed to evaluate the effectiveness of public access defibrillation, but it is unclear whether such early defibrillation will offer sufficient value for money.
Our objective was to estimate the potential cost-effectiveness of public access defibrillation by use of decision analysis.
Methods and Results-A decision model compared the potential cost-effectiveness of standard emergency medical services (EMS) systems with that of EMS supplemented by PAD.
We considered defibrillation by lay responders or police, using an analysis with a US health-care perspective.
Input data were derived from published data or fiscal databases.
Future costs and effects were discounted at 3%. Monte Carlo simulation was performed to estimate the variability in the costs and effects of each program.
Sensitivity analyses assessed the robustness of the results to changes in input data.
A standard EMS system had a median cost of $5900 per cardiac arrest patient (interquartile range, IQR, $3200 to $10 900) and yielded a median of 0.25 quality-adjusted life years (IQR, 0.20 to 0.30). (...)
Mots-clés Pascal : Fibrillation ventriculaire, Défibrillation, Précoce, Organisation santé, Individu, Formation professionnelle, Analyse coût efficacité, Economie santé, Etats Unis, Amérique du Nord, Amérique, Traitement, Homme, Appareil circulatoire pathologie, Cardiopathie, Trouble rythme cardiaque, Trouble excitabilité, Réanimation cardiocirculatoire, Traitement instrumental
Mots-clés Pascal anglais : Ventricular fibrillation, Defibrillation, Early, Public health organization, Individual, Occupational training, Cost efficiency analysis, Health economy, United States, North America, America, Treatment, Human, Cardiovascular disease, Heart disease, Arrhythmia, Excitability disorder, Intensive cardiocirculatory care, Instrumentation therapy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0232776
Code Inist : 002B12A02. Création : 11/09/1998.