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Cost-effectiveness of Automated External Defibrillator Deployment in Selected Public Locations
dc.contributor.authorCram, Peteren_US
dc.contributor.authorVijan, Sandeepen_US
dc.contributor.authorFendrick, A. Marken_US
dc.date.accessioned2010-06-01T19:24:18Z
dc.date.available2010-06-01T19:24:18Z
dc.date.issued2003-09en_US
dc.identifier.citationCram, Peter; Vijan, Sandeep; Fendrick, A. Mark (2003). "Cost-effectiveness of Automated External Defibrillator Deployment in Selected Public Locations." Journal of General Internal Medicine 18(9): 745-754. <http://hdl.handle.net/2027.42/72546>en_US
dc.identifier.issn0884-8734en_US
dc.identifier.issn1525-1497en_US
dc.identifier.urihttps://hdl.handle.net/2027.42/72546
dc.identifier.urihttp://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=12950484&dopt=citationen_US
dc.description.abstractThe American Heart Association (AHA) recommends an automated external defibrillator (AED) be considered for a specific location if there is at least a 20% annual probability the device will be used. We sought to evaluate the cost-effectiveness of the AHA recommendation and of AED deployment in selected public locations with known cardiac arrest rates. DESIGN: Markov Decision Model employing a societal perspective. SETTING: Selected public locations in the United States. PATIENTS: A simulated cohort of the American public. INTERVENTION: Strategy 1: individuals experiencing cardiac arrest were treated by emergency medical services equipped with AEDs (EMS-D). Strategy 2: individuals were treated with AEDs deployed as part of a public access defibrillation program. Strategies differed only in the initial availability of an AED and its impact on cardiac arrest survival. RESULTS: Under the base-case assumption that a deployed AED will be used on 1 cardiac arrest every 5 years (20% annual probability of AED use), the cost per quality-adjusted life year (QALY) gained is $30,000 for AED deployment compared with EMS-D care. AED deployment costs less than $50,000 per QALY gained provided that the annual probability of AED use is 12% or greater. Monte Carlo simulation conducted while holding the annual probability of AED use at 20% demonstrated that 87% of the trials had a cost-effectiveness ratio of less than $50,000 per QALY. CONCLUSIONS: AED deployment is likely to be cost-effective across a range of public locations. The current AHA guidelines are overly restrictive. Limited expansion of these programs can be justified on clinical and economic grounds.en_US
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dc.format.extent3109 bytes
dc.format.mimetypeapplication/pdf
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dc.publisherBlackwell Science Incen_US
dc.rights2003 by the Society of General Internal Medicineen_US
dc.subject.otherEmergency Medical Servicesen_US
dc.subject.otherHeart Arresten_US
dc.subject.otherElectric Countershocken_US
dc.subject.otherPublic Access Defibrillationen_US
dc.titleCost-effectiveness of Automated External Defibrillator Deployment in Selected Public Locationsen_US
dc.typeArticleen_US
dc.subject.hlbsecondlevelInternal Medicine and Specialtiesen_US
dc.subject.hlbtoplevelHealth Sciencesen_US
dc.description.peerreviewedPeer Revieweden_US
dc.contributor.affiliationumReceived from the Division of General Medicine, Department of Internal Medicine (PC), University of Iowa College of Medicine, Iowa City, Iowa; and Division of General Medicine, Department of Internal Medicine, University of Michigan School of Medicine (SV, AMF), Consortium for Health Outcomes, Innovation, and Cost Effectiveness Studies (AMF), Ann Arbor Veterans Affairs Health Services Research and Development Field Program (SV), and Department of Health Management and Policy, University of Michigan School of Public Health (AMF), Ann Arbor, Mich.en_US
dc.identifier.pmid12950484en_US
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/72546/1/j.1525-1497.2003.21139.x.pdf
dc.identifier.doi10.1046/j.1525-1497.2003.21139.xen_US
dc.identifier.sourceJournal of General Internal Medicineen_US
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dc.owningcollnameInterdisciplinary and Peer-Reviewed


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