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Cost-effectiveness of In-home Automated External Defibrillators for Individuals at Increased Risk of Sudden Cardiac Death
dc.contributor.authorCram, Peteren_US
dc.contributor.authorVijan, Sandeepen_US
dc.contributor.authorKatz, Daviden_US
dc.contributor.authorFendrick, A. Marken_US
dc.date.accessioned2010-06-01T18:58:39Z
dc.date.available2010-06-01T18:58:39Z
dc.date.issued2005-03en_US
dc.identifier.citationCram, 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.issn0884-8734en_US
dc.identifier.issn1525-1497en_US
dc.identifier.urihttps://hdl.handle.net/2027.42/72168
dc.identifier.urihttp://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=15836529&dopt=citationen_US
dc.description.abstractIn-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
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dc.format.extent3109 bytes
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dc.publisherBlackwell Science Incen_US
dc.rights© 2005 by the Society of General Internal Medicine. All rights reserveden_US
dc.subject.otherEmergency Medical Servicesen_US
dc.subject.otherHeart Arresten_US
dc.subject.otherDefibrillators.en_US
dc.titleCost-effectiveness of In-home Automated External Defibrillators for Individuals at Increased Risk of Sudden Cardiac Deathen_US
dc.typeArticleen_US
dc.subject.hlbsecondlevelInternal Medicine and Specialtiesen_US
dc.subject.hlbtoplevelHealth Sciencesen_US
dc.description.peerreviewedPeer Revieweden_US
dc.contributor.affiliationumDivision of General Medicine, Department of Internal Medicine, University of Michigan School of Medicine, Ann Arbor, MI, USA ;en_US
dc.contributor.affiliationumDepartment of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA ;en_US
dc.contributor.affiliationumConsortium for Health Outcomes, Innovation, and Cost Effectiveness Studies (CHOICES), University of Michigan School of Medicine, Ann Arbor, MI, USA .en_US
dc.contributor.affiliationotherDivision of General Medicine, Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, IA, USA ;en_US
dc.contributor.affiliationotherAnn Arbor Veterans Affairs Health Services Research and Development Field Program, Ann Arbor, MI, USA ;en_US
dc.contributor.affiliationotherDepartment of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USA ;en_US
dc.identifier.pmid15836529en_US
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/72168/1/j.1525-1497.2005.40247.x.pdf
dc.identifier.doi10.1111/j.1525-1497.2005.40247.xen_US
dc.identifier.sourceJournal of General Internal Medicineen_US
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