Estimated cost effectiveness of a police automated external defibrillator program in a suburban community:: 7 years experience

• Published in: Resuscitation 2002, Vol.52 (1), p.23-29
• Main Authors: Forrer, Christian S, Swor, Robert A., Jackson, Raymond E, Pascual, Rebecca G, Compton, Scott, McEachin, Christine
• Format: Article
• Language: English
• Subjects: Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Automation; Biological and medical sciences; Cardiac arrest; Cardiopulmonary Resuscitation - economics; Cardiopulmonary Resuscitation - statistics & numerical data; Cost effectiveness; Cost-Benefit Analysis; Defibrillation; Electric Countershock - economics; Electric Countershock - statistics & numerical data; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Emergency Medical Services - economics; Emergency Medical Services - statistics & numerical data; Female; Health Promotion - economics; Heart Arrest - mortality; Heart Arrest - therapy; Humans; Intensive care medicine; Male; Medical sciences; Middle Aged; Police; Probability; Program Development; Program Evaluation; Retrospective Studies; Suburban Population; Survival Analysis; Time Factors; United States
• ISSN: 0300-9572; 1873-1570
• DOI: 10.1016/S0300-9572(01)00430-0

Objective: To estimate the cost effectiveness of a 7-year police automatic external defibrillator (AED) program in four suburban communities. Method: 10-year retrospective study (7/89–7/99) of patients of four suburban communities during two study periods: (1) police first response and advanced life support (ALS) care (No-AED) and; (2) AED equipped police first response (P-AED) with subsequent ALS care. Using the perspective of the communities, we obtained costs of AED program from police agencies. We estimated cost/life saved and cost/year lives saved using decreased time to VF shock by EMS. We performed a sensitivity analysis for estimates of potential benefit using estimated improved survival as a result of decreased EMS response interval and obtained survival data. We used literature-based estimates of life expectancy after cardiac arrest survival to estimate cost/year life saved. We used student's t-test and χ 2 to estimate differences between groups. Results: During the 10-year study period 208 patients met study criteria; (81 No-AED, 128 P-AED). The two groups were not different by patient age, ALS response interval, percent in VF, percent witnessed (WIT), or arrest location. Interval to first defibrillator equipped EMS vehicle arrival was less in the P-AED group (2.0 vs. 5.4 min, P