title: Health care costs related to out-of-hospital cardiopulmonary arrest in Japan.
abstract: OBJECTIVE
  Although cost analyses for emergency care are essential, data on costs of care for out-of-hospital cardiopulmonary arrest (OHCA) are scarce. The present study aimed to analyze health care costs related to OHCA using a nationwide administrative database in Japan.
  
  
  METHODS
  Using the Diagnosis Procedure Combination database in Japan, we identified OHCA patients who were transported to 779 emergency medical centres between July and December in 2008 and 2009. We assessed patient survival and discharge status, receipt of specific treatments, and costs of in-hospital care.
  
  
  RESULTS
  A total of 21,750 OHCA patients were identified. Overall, 59.6% were males, and the average age was 70.3 years. Of them, 1394 (6.4%) resulted in death without attempted resuscitation after hospital arrival (Group A), 14,973 (69.0%) died on admission day despite resuscitation attempts (Group B), 3680 (17.0%) died at ≥2 days after admission despite resuscitation attempts (Group C), 785 (3.6%) survived and were discharged to home (Group D) and 873 (4.0%) survived and discharged to other than home (Group E). The median total costs were $434, $1735, $4869, $28,097 and $31,161 in Groups A to E, respectively. Positive survival status, longer hospital stay and receipt of specific treatments were significant predictors of higher total costs. After adjustment for these factors, higher age was associated with lower costs.
  
  
  CONCLUSIONS
  The findings in the present study add further evidence to existing knowledge about healthcare costs related to OHCA.
authors.affiliation: Department of Emergency and Critical Care Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors.forename: Tatsuma
authors.initials: T
authors.lastname: Fukuda
authors.forename: Hideo
authors.initials: H
authors.lastname: Yasunaga
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Horiguchi
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Ohe
authors.forename: Kiyohide
authors.initials: K
authors.lastname: Fushimi
authors.forename: Takehiro
authors.initials: T
authors.lastname: Matsubara
authors.forename: Naoki
authors.initials: N
authors.lastname: Yahagi
mesh_terms: D000367:Age Factors; D000368:Aged; D001803:Blood Transfusion / Q000191:economics / Q000706:statistics & numerical data; D016887:Cardiopulmonary Resuscitation; D013504:Cardiovascular Surgical Procedures / Q000191:economics / Q000706:statistics & numerical data; D016208:Databases, Factual; D015199:Extracorporeal Membrane Oxygenation / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000191:economics / Q000706:statistics & numerical data; D007564:Japan / Q000453:epidemiology; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D058687:Out-of-Hospital Cardiac Arrest / Q000191:economics* / Q000453:epidemiology; D010138:Pacemaker, Artificial / Q000191:economics / Q000706:statistics & numerical data; D010351:Patient Discharge