Estimated cost effectiveness of a police automated external defibrillator program in a suburban community:: 7 years experience
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...
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| Veröffentlicht in: | Resuscitation 2002, Vol.52 (1), p.23-29 |
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| creator | Forrer, Christian S Swor, Robert A. Jackson, Raymond E Pascual, Rebecca G Compton, Scott McEachin, Christine |
| description | 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 |
| doi_str_mv | 10.1016/S0300-9572(01)00430-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_71400485</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0300957201004300</els_id><sourcerecordid>71400485</sourcerecordid><originalsourceid>FETCH-LOGICAL-e293t-6bf3dde479605f43479efd7d631424489e411d88e1cfc8b7ee01102ea6bdcec13</originalsourceid><addsrcrecordid>eNpFkc1uFDEQhC0ESjYhjwDyBZQcBrrXnvFMLghFSUCKlEPgbHnsNjKan8X2ROyFZ8fZXcip-_B1qbqKsTcIHxCw-fgAAqDqarU-B7wAkAIqeMFW2CpRYa3gJVv9R47ZSUo_AUDUnTpix4gtoJD1iv25TjmMJpPjdk6Zk_dkc3ikiVLis-eGb-YhWOJmyfMepN-Z4mQG7siHPoZhMHmOfBPnH9GMPEzlKC39EnszFdVxXKaQt5eXXPEtmZiKwIZioMnSa_bKmyHR2WGesu8319-uvlR397dfrz7fVbTuRK6a3gvnSKqugdpLURbyTrlGoFxL2XYkEV3bElpv214RASKsyTS9s2RRnLL3e91i8tdCKesxJEvF-UTzkrRCWSJs6wK-PYBLP5LTm1jSiVv9L7ECvDsAJlkz-GgmG9IzJ4pK3YjCfdpzVN56DBR1sruXXYglYe3moBH0U5d616V-KkoD6l2XGsRfRXmRug</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>71400485</pqid></control><display><type>article</type><title>Estimated cost effectiveness of a police automated external defibrillator program in a suburban community:: 7 years experience</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Forrer, Christian S ; Swor, Robert A. ; Jackson, Raymond E ; Pascual, Rebecca G ; Compton, Scott ; McEachin, Christine</creator><creatorcontrib>Forrer, Christian S ; Swor, Robert A. ; Jackson, Raymond E ; Pascual, Rebecca G ; Compton, Scott ; McEachin, Christine</creatorcontrib><description>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<0.001) as was the interval from the emergency (911) call to first VF shock (6.6 vs. 8.4 min,
P=0.02). Survival to DC was not statistically different with P-AED (11.9 vs. 9.9%,
P=0.66) but this study was not powered to detect a difference. Estimated cost per life saved with P-AED varied from $23 542 to $70 342 and cost per year life saved ranged from $1582 to $16 060.
Conclusion: Police AED appears to be a cost-effective intervention in these suburban communities which have relatively rapid EMS response intervals.</description><identifier>ISSN: 0300-9572</identifier><identifier>EISSN: 1873-1570</identifier><identifier>DOI: 10.1016/S0300-9572(01)00430-0</identifier><identifier>PMID: 11801345</identifier><identifier>CODEN: RSUSBS</identifier><language>eng</language><publisher>Shannon: Elsevier Ireland Ltd</publisher><subject>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</subject><ispartof>Resuscitation, 2002, Vol.52 (1), p.23-29</ispartof><rights>2002 Elsevier Science Ireland Ltd</rights><rights>2002 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0300957201004300$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,4010,27900,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13485563$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11801345$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Forrer, Christian S</creatorcontrib><creatorcontrib>Swor, Robert A.</creatorcontrib><creatorcontrib>Jackson, Raymond E</creatorcontrib><creatorcontrib>Pascual, Rebecca G</creatorcontrib><creatorcontrib>Compton, Scott</creatorcontrib><creatorcontrib>McEachin, Christine</creatorcontrib><title>Estimated cost effectiveness of a police automated external defibrillator program in a suburban community:: 7 years experience</title><title>Resuscitation</title><addtitle>Resuscitation</addtitle><description>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<0.001) as was the interval from the emergency (911) call to first VF shock (6.6 vs. 8.4 min,
P=0.02). Survival to DC was not statistically different with P-AED (11.9 vs. 9.9%,
P=0.66) but this study was not powered to detect a difference. Estimated cost per life saved with P-AED varied from $23 542 to $70 342 and cost per year life saved ranged from $1582 to $16 060.
Conclusion: Police AED appears to be a cost-effective intervention in these suburban communities which have relatively rapid EMS response intervals.</description><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Automation</subject><subject>Biological and medical sciences</subject><subject>Cardiac arrest</subject><subject>Cardiopulmonary Resuscitation - economics</subject><subject>Cardiopulmonary Resuscitation - statistics & numerical data</subject><subject>Cost effectiveness</subject><subject>Cost-Benefit Analysis</subject><subject>Defibrillation</subject><subject>Electric Countershock - economics</subject><subject>Electric Countershock - statistics & numerical data</subject><subject>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</subject><subject>Emergency Medical Services - economics</subject><subject>Emergency Medical Services - statistics & numerical data</subject><subject>Female</subject><subject>Health Promotion - economics</subject><subject>Heart Arrest - mortality</subject><subject>Heart Arrest - therapy</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Police</subject><subject>Probability</subject><subject>Program Development</subject><subject>Program Evaluation</subject><subject>Retrospective Studies</subject><subject>Suburban Population</subject><subject>Survival Analysis</subject><subject>Time Factors</subject><subject>United States</subject><issn>0300-9572</issn><issn>1873-1570</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkc1uFDEQhC0ESjYhjwDyBZQcBrrXnvFMLghFSUCKlEPgbHnsNjKan8X2ROyFZ8fZXcip-_B1qbqKsTcIHxCw-fgAAqDqarU-B7wAkAIqeMFW2CpRYa3gJVv9R47ZSUo_AUDUnTpix4gtoJD1iv25TjmMJpPjdk6Zk_dkc3ikiVLis-eGb-YhWOJmyfMepN-Z4mQG7siHPoZhMHmOfBPnH9GMPEzlKC39EnszFdVxXKaQt5eXXPEtmZiKwIZioMnSa_bKmyHR2WGesu8319-uvlR397dfrz7fVbTuRK6a3gvnSKqugdpLURbyTrlGoFxL2XYkEV3bElpv214RASKsyTS9s2RRnLL3e91i8tdCKesxJEvF-UTzkrRCWSJs6wK-PYBLP5LTm1jSiVv9L7ECvDsAJlkz-GgmG9IzJ4pK3YjCfdpzVN56DBR1sruXXYglYe3moBH0U5d616V-KkoD6l2XGsRfRXmRug</recordid><startdate>2002</startdate><enddate>2002</enddate><creator>Forrer, Christian S</creator><creator>Swor, Robert A.</creator><creator>Jackson, Raymond E</creator><creator>Pascual, Rebecca G</creator><creator>Compton, Scott</creator><creator>McEachin, Christine</creator><general>Elsevier Ireland Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>2002</creationdate><title>Estimated cost effectiveness of a police automated external defibrillator program in a suburban community:: 7 years experience</title><author>Forrer, Christian S ; Swor, Robert A. ; Jackson, Raymond E ; Pascual, Rebecca G ; Compton, Scott ; McEachin, Christine</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-e293t-6bf3dde479605f43479efd7d631424489e411d88e1cfc8b7ee01102ea6bdcec13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Automation</topic><topic>Biological and medical sciences</topic><topic>Cardiac arrest</topic><topic>Cardiopulmonary Resuscitation - economics</topic><topic>Cardiopulmonary Resuscitation - statistics & numerical data</topic><topic>Cost effectiveness</topic><topic>Cost-Benefit Analysis</topic><topic>Defibrillation</topic><topic>Electric Countershock - economics</topic><topic>Electric Countershock - statistics & numerical data</topic><topic>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</topic><topic>Emergency Medical Services - economics</topic><topic>Emergency Medical Services - statistics & numerical data</topic><topic>Female</topic><topic>Health Promotion - economics</topic><topic>Heart Arrest - mortality</topic><topic>Heart Arrest - therapy</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Police</topic><topic>Probability</topic><topic>Program Development</topic><topic>Program Evaluation</topic><topic>Retrospective Studies</topic><topic>Suburban Population</topic><topic>Survival Analysis</topic><topic>Time Factors</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Forrer, Christian S</creatorcontrib><creatorcontrib>Swor, Robert A.</creatorcontrib><creatorcontrib>Jackson, Raymond E</creatorcontrib><creatorcontrib>Pascual, Rebecca G</creatorcontrib><creatorcontrib>Compton, Scott</creatorcontrib><creatorcontrib>McEachin, Christine</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Resuscitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Forrer, Christian S</au><au>Swor, Robert A.</au><au>Jackson, Raymond E</au><au>Pascual, Rebecca G</au><au>Compton, Scott</au><au>McEachin, Christine</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Estimated cost effectiveness of a police automated external defibrillator program in a suburban community:: 7 years experience</atitle><jtitle>Resuscitation</jtitle><addtitle>Resuscitation</addtitle><date>2002</date><risdate>2002</risdate><volume>52</volume><issue>1</issue><spage>23</spage><epage>29</epage><pages>23-29</pages><issn>0300-9572</issn><eissn>1873-1570</eissn><coden>RSUSBS</coden><abstract>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<0.001) as was the interval from the emergency (911) call to first VF shock (6.6 vs. 8.4 min,
P=0.02). Survival to DC was not statistically different with P-AED (11.9 vs. 9.9%,
P=0.66) but this study was not powered to detect a difference. Estimated cost per life saved with P-AED varied from $23 542 to $70 342 and cost per year life saved ranged from $1582 to $16 060.
Conclusion: Police AED appears to be a cost-effective intervention in these suburban communities which have relatively rapid EMS response intervals.</abstract><cop>Shannon</cop><pub>Elsevier Ireland Ltd</pub><pmid>11801345</pmid><doi>10.1016/S0300-9572(01)00430-0</doi><tpages>7</tpages></addata></record> |
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| 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 |
| title | Estimated cost effectiveness of a police automated external defibrillator program in a suburban community:: 7 years experience |
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