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School of Business, Örebro University Working Papers, School of Business, Örebro University

No 2010:13:
Favourable cost-benefit in an early defibrillation program using dual dispatch of ambulance and fire services in out-of-hospital cardiac arrest

Björn Sund (), Leif Svensson, Mårten Rosenqvist and Jacob Hollenberg

Abstract:

Aims: Out-of-hospital cardiac arrest (OHCA) is fatal without treatment and time to defibrillation is an extremely important factor in relation to survival. We performed a cost-benefit analysis of dual dispatch defibrillation by ambulance and fire services in the County of Stockholm, Sweden.

Methods and Results: A cost-benefit analysis was performed to evaluate the effects of dual dispatch defibrillation. The increased survival rates were estimated from a real world implemented intervention and the monetary value of a life (€ 2.2 million) was applied to this benefit by using results from a recent stated-preference study. The estimated costs include defibrillators (including expendables/maintenance), training, hospitalisation/health care, call-outs for the fire services, overhead resources and costs for the dispatch centre. The estimated number of additional saved lives was 16 per year, yielding a benefit-cost ratio of 36. The cost per quality-adjusted life years (QALY) was estimated to be € 13 000 and the cost per saved life was € 60 000.

Conclusions: The intervention of dual dispatch defibrillation by ambulance and fire services in the County of Stockholm had positive economic effects. For the cost-benefit analysis the return on investment was high and the cost-effectiveness showed levels below the threshold value for economic efficiency used in Sweden. The cost-utility analysis categorises the cost per QALY as medium.

Keywords: Cost-benefit analysis; cost-utility analysis; cost-effectiveness analysis; cardiac arrest; defibrillation; ambulance; fire services; (follow links to similar papers)

JEL-Codes: D61; H43; I18; (follow links to similar papers)

26 pages, October 19, 2010

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