ArticleBMJ (Clinical research ed.)2003
Cost effectiveness and cost utility model of public place defibrillators in improving survival after prehospital cardiopulmonary arrest.
Article in BMJ (Clinical research ed.), 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed.
- Trial
- Cost-effectiveness of a community first responder system for out-of-hospital cardiac arrest in Belgium.Open heart · 2025Article
- Cost-Effectiveness of a Community First Responder System for Out-of-Hospital Cardiac Arrest in Poland.ClinicoEconomics and outcomes research : CEOR · 2025Article
- A systematic review of cost-effectiveness of treating out of hospital cardiac arrest and the implications for resource-limited health systems.International journal of emergency medicine · 2024Review
- A Systematic Review of Cost-Effectiveness of Treating Out of Hospital Cardiac Arrest: Implications for Resource-limited Health Systems.Research square · 2024Article
- Article
- Favourable cost-benefit in an early defibrillation programme using dual dispatch of ambulance and fire services in out-of-hospital cardiac arrest.The European journal of health economics : HEPAC : health economics in prevention and care · 2012Article
- Out of hospital cardiac arrest outside home in Sweden, change in characteristics, outcome and availability for public access defibrillation.Scandinavian journal of trauma, resuscitation and emergency medicine · 2009Article
- Ventricular fibrillation and defibrillation.Archives of disease in childhood · 2007Review
- [Public access defibrillation. Limited use by trained first responders and laymen].Der Anaesthesist · 2006Review
- Need for differential discounting of costs and health effects in cost effectiveness analyses.BMJ (Clinical research ed.) · 2005Article
- Use of automated external defibrillators in cardiac arrest: an evidence-based analysis.Ontario health technology assessment series · 2005Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the cost effectiveness and cost utility of locating defibrillators in all major airports, railway stations, and bus stations throughout Scotland.
designEconomic modelling exercise with data from Heartstart (Scotland). Parameters used in economic model included direct costs derived for increased accident and emergency attendances, increased hospital bed days, purchase and maintenance of defibrillators, and training in their use; life years gained calculated from increased discharges from hospital and mean survival after discharge; utility (quality of life) obtained from published data. Sensitivity analyses tested the robustness of model. Future gains discounted at 1.5% a year and future costs at 6%.
settingWhole of Scotland. SUBJECTS: Records of all prehospital cardiac arrests due to presumed heart disease that occurred in a major airport, railway, or bus station between May 1991 and March 1998 and were not witnessed by ambulance or medical staff.
main outcome measuresObserved survival to hospital admission and observed survival to discharge. Predicted survival calculated by applying observed survival in patients attended by ambulance staff within three minutes to those who waited longer.
resultsThe total discounted direct costs were 18 325 pounds sterling a year. The cost per life year gained was 29 625 pounds sterling (49 625 dollars, 43 151 Euros) and the cost per quality adjusted life year (QALY) gained was pound 41 146 (68 924 dollars, 59 932 Euros). More widespread provision of public place defibrillators would increase these figures.
conclusionsThe cost per QALY calculated for public place defibrillators represents poorer value for money than some alternative strategies for improving survival after prehospital cardiopulmonary arrest, such as the use of other trained first responders. The figure exceeds the commonly discussed cut off levels for funding in the United Kingdom and United States of pound 30 000 and 50 000 dollars per QALY, respectively.
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