A proposed model for the cost of cardiopulmonary resuscitation.
In-hospital cardiopulmonary resuscitation (CPR) is associated with substantial costs beyond those of the resuscitation itself. These costs are important to understand because health care resources are limited. To that end, a model of CPR is proposed, including an examination of the effect of several variables on the cost per patient surviving to discharge. The cost of CPR was estimated using a model that describes the CPR process as a series of decision points, each with an associated survival rate and cost. Sensitivity analyses were performed for critical variables to examine their effect on cost. The cost per patient surviving to discharge increases exponentially as the rate of survival to discharge decreases. This cost was $117,000 for a rate of survival to discharge of 10%, $248,271 for a rate of 1%, and $544,521 for a rate of 0.2%. Analysis of the model shows that health care costs related to CPR could be reduced most by decreasing the hospital length of stay and charges for patients who survive the initial resuscitation event, by increases in the overall survival rate, and by the prospective stratification of hospitalized patients according to their anticipated response to resuscitation efforts. The model allows the marginal cost-effectiveness of CPR to be quantitatively evaluated relative to survival rate.
Ebell
M H
MH
Wayne State University School of Medicine, Detroit, MI.
Kruse
J A
JA
D016887:Cardiopulmonary Resuscitation / Q000191:economics*; D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D006323:Heart Arrest / Q000191:economics / Q000401:mortality / Q000628:therapy; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D017059:Models, Econometric; D017063:Outcome Assessment, Health Care / Q000191:economics; D011788:Quality of Life; D015996:Survival Rate; D017741:Survivors; D014481:United States; D026712:Value of Life