Format

Send to:

Choose Destination
See comment in PubMed Commons below
J Gen Intern Med. 2005 Mar;20(3):251-8.

Cost-effectiveness of in-home automated external defibrillators for individuals at increased risk of sudden cardiac death.

Author information

  • 1Division of General Medicine, Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, IA, USA. peter-cram@uiowa.edu <peter-cram@uiowa.edu>

Abstract

BACKGROUND/OBJECTIVE:

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 dollars. 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 dollars, 104,000 dollars, and 88,000 dollars, 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.

PMID:
15836529
[PubMed - indexed for MEDLINE]
PMCID:
PMC1490077
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for PubMed Central
    Loading ...
    Write to the Help Desk