Automated external defibrillators in long-term care facilities are cost-effective.
OBJECTIVE
To assess the cost per life saved of equipping long-term care facilities (LTCFs) with automated external defibrillators (AEDs).


METHODS
Outcomes for cardiac arrests within LTCFs were retrieved for 1994 to 1997 from a comprehensive out-of-hospital cardiac arrest registry in a mid-sized U.S. city. The total expense for all LTCFs to obtain and maintain AEDs and to educate and maintain staff skill was estimated for a theoretical four-year period. The cost per life saved to the time of hospital discharge was calculated based on an estimated survival rate of 25% of patients found in ventricular fibrillation (VF) with placement of AEDs in LTCFs. A sensitivity analysis that varied survival rates and costs was conducted.


RESULTS
Over four years, there were 160 actual arrests in 43 LTCFs, with a hospital discharge survival rate of 2/160. Twenty of 160 presented to emergency medical services in VF. Training costs for four years were $1,225 per AED. Purchase and maintenance expenses for one AED over four years were $3,941. Placing AEDs in LTCFs would cost $87,837 per life saved if 25% of patients found in VF survived to hospital discharge. Sensitivity analysis using survival rates of 5%, 15%, and 35% established the cost per life saved at $439,184, $146,395, and $62,741, respectively. When costs were calculated at one-half and twice the estimated expense, the cost per life saved was $43,918 and $175,674, respectively.


CONCLUSIONS
Placing AEDs in LTCFs is cost-effective at $87,837 per life saved, if a hospital discharge survival rate of 25% of patients in VF can be achieved.
Foutz
R A
RA
Department of Emergency Medicine, University of Cincinnati College of Medicine, Ohio 42567-0769, USA.
Sayre
M R
MR
D003362:Cost-Benefit Analysis; D004554:Electric Countershock / Q000191:economics* / Q000295:instrumentation; D004632:Emergency Medical Services / Q000191:economics*; D006323:Heart Arrest / Q000191:economics / Q000628:therapy*; D006801:Humans; D007318:Inservice Training / Q000191:economics; D009735:Nursing Homes / Q000191:economics*; D009820:Ohio; D010561:Personnel Staffing and Scheduling / Q000191:economics; D015996:Survival Rate; D026712:Value of Life; D014693:Ventricular Fibrillation / Q000191:economics / Q000628:therapy