title: Favourable cost-benefit in an early defibrillation programme using dual dispatch of ambulance and fire services in out-of-hospital cardiac arrest.
abstract: OBJECTIVE
  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.
  
  
  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 (<euro> 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 <euro> 13,000, and the cost per saved life was <euro> 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.
authors: Swedish Business School, Örebro University, 702 82, Örebro, Sweden. bjorn.sund@msb.se
authors: Björn
authors: B
authors: Sund
authors: Leif
authors: L
authors: Svensson
authors: Mårten
authors: M
authors: Rosenqvist
authors: Jacob
authors: J
authors: Hollenberg
mesh_terms: D003362:Cost-Benefit Analysis; D047548:Defibrillators; D004632:Emergency Medical Services / Q000191:economics* / Q000379:methods; D006760:Hospitalization; D006801:Humans; D058687:Out-of-Hospital Cardiac Arrest / Q000191:economics / Q000628:therapy*; D019057:Quality-Adjusted Life Years; D013548:Sweden