Cost-effectiveness of In-home Automated External Defibrillators for Individuals at Increased Risk of Sudden Cardiac Death
dc.contributor.author | Cram, Peter | en_US |
dc.contributor.author | Vijan, Sandeep | en_US |
dc.contributor.author | Katz, David | en_US |
dc.contributor.author | Fendrick, A. Mark | en_US |
dc.date.accessioned | 2010-06-01T18:58:39Z | |
dc.date.available | 2010-06-01T18:58:39Z | |
dc.date.issued | 2005-03 | en_US |
dc.identifier.citation | Cram, Peter; Vijan, Sandeep; Katz, David; Fendrick, A . Mark (2005). "Cost-effectiveness of In-home Automated External Defibrillators for Individuals at Increased Risk of Sudden Cardiac Death." Journal of General Internal Medicine 20(3): 251-258. <http://hdl.handle.net/2027.42/72168> | en_US |
dc.identifier.issn | 0884-8734 | en_US |
dc.identifier.issn | 1525-1497 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/72168 | |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=15836529&dopt=citation | en_US |
dc.description.abstract | 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. | en_US |
dc.format.extent | 182810 bytes | |
dc.format.extent | 3109 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.publisher | Blackwell Science Inc | en_US |
dc.rights | © 2005 by the Society of General Internal Medicine. All rights reserved | en_US |
dc.subject.other | Emergency Medical Services | en_US |
dc.subject.other | Heart Arrest | en_US |
dc.subject.other | Defibrillators. | en_US |
dc.title | Cost-effectiveness of In-home Automated External Defibrillators for Individuals at Increased Risk of Sudden Cardiac Death | en_US |
dc.type | Article | en_US |
dc.subject.hlbsecondlevel | Internal Medicine and Specialties | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Division of General Medicine, Department of Internal Medicine, University of Michigan School of Medicine, Ann Arbor, MI, USA ; | en_US |
dc.contributor.affiliationum | Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA ; | en_US |
dc.contributor.affiliationum | Consortium for Health Outcomes, Innovation, and Cost Effectiveness Studies (CHOICES), University of Michigan School of Medicine, Ann Arbor, MI, USA . | en_US |
dc.contributor.affiliationother | Division of General Medicine, Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, IA, USA ; | en_US |
dc.contributor.affiliationother | Ann Arbor Veterans Affairs Health Services Research and Development Field Program, Ann Arbor, MI, USA ; | en_US |
dc.contributor.affiliationother | Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USA ; | en_US |
dc.identifier.pmid | 15836529 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/72168/1/j.1525-1497.2005.40247.x.pdf | |
dc.identifier.doi | 10.1111/j.1525-1497.2005.40247.x | en_US |
dc.identifier.source | Journal of General Internal Medicine | en_US |
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dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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