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Cost Effectiveness of Suburban Police Early Defibrillation Programs - 7 Years' Experience added 4/28/01

Academic Emergency Medicine Volume 7, Number 5 430,

Robert A Swor, Raymond E Jackson, Kevin H Chu, Rebecca G Pascual, Scott Compton and Chris McEachin William Beaumont Hospital, Royal Oak, MI

ABSTRACT

Objective: To calculate the cost effectiveness of a 7 year Police AED program in 4 suburban communities.
Method: 10 year retrospective study (7/89-7/99) of patients of 4 suburban communities during two study periods:
    1) Police first response and ALS care (No-AED) and
    2) AED equipped police first response (P-AED) with subsequent ALS care.
Utstein data elements including survival to discharge were collected.
Costs for AED program were obtained from police agencies.

Cost/life saved and cost/year life saved were calculated using three methods:
   1) Obtained survival data;
   2) Estimated improved survival using improved response interval and
   3) Improved time to shock data.
Literature based estimates of life expectancy after cardiac arrest survival were used to estimate cost/year life saved. Student's t-test and chi square were used for analysis.

Results: 213 pts met study criteria; (81 No-AED, and 132 P-AED). The two groups were not different by pt age, ALS response interval, % VF, % witnessed (wit), or arrest location. Interval to first defibrillator equipped EMS arrival was significantly less in the P-AED group (2.0 vs 5.4 minutes, p<0.001) as was the interval from 911 call to first VF shock (6.6 vs 8.4 minutes, p=0.02). Survival to discharge was improved with P-AED (12.5% vs 9.8%, p=0.56) but was not statistically significant.

Cost/life saved varied from $22,939 to $37,467, and cost/year/life saved ranged from $5,237 to $8,554.

Conclusion: Police AED is a cost effective intervention in these suburban communities which have relatively rapid EMS response intervals.