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Favourable cost-benefit in an early defibrillation programme using dual dispatch of ambulance and fire services in out-of-hospital cardiac arrest

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The European Journal of Health Economics Aims and scope Submit manuscript

Abstract

Aims

Out-of-hospital cardiac arrest 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, fire service call-outs, overhead resources and 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.

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Acknowledgments

We would like to thank Peter Frykblom, Catharina Hjortsberg, Lars Hultkrantz, Henrik Jaldell, Ulf Persson and Mikael Svensson for helpful comments and Mikael Gustafsson, Lars Hallander, Åke Karlsson and Britt Stålhandske for research assistance. This work was supported by the Swedish Civil Contingencies Agency, which had no role in the study design, in the collection, analysis or interpretation of data, in the writing of the manuscript or in the decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Swedish Business School, Örebro University, 702 82, Örebro, Sweden

    Björn Sund

  2. Department of Cardiology, South Hospital, Karolinska Institute, Stockholm, Sweden

    Leif Svensson, Mårten Rosenqvist & Jacob Hollenberg

Authors
  1. Björn Sund
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  2. Leif Svensson
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  3. Mårten Rosenqvist
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  4. Jacob Hollenberg
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Corresponding author

Correspondence to Björn Sund.

Appendix

Appendix

See Table 4.

Table 4 Summary of the cost parameters
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Sund, B., Svensson, L., Rosenqvist, M. et al. Favourable cost-benefit in an early defibrillation programme using dual dispatch of ambulance and fire services in out-of-hospital cardiac arrest. Eur J Health Econ 13, 811–818 (2012). https://doi.org/10.1007/s10198-011-0338-7

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