COST-EFFECTIVENESS ANALYSIS OF PARAMEDIC EMERGENCY MEDICAL-SERVICES IN THE TREATMENT OF PREHOSPITAL CARDIOPULMONARY ARREST

Study objectives: 1) Identification of marginal costs associated with prehospital resuscitation of cardiopulmonary arrest; 2) Determination of cost effectiveness for such resuscitation; and 3) Comparison of cost effectiveness of paramedic care with selected other medical interventions. Design: Retrospective review of 190 cases of out-of-hospital cardiac arrest. Setting: City limits of a midsized southwestern city. The events studied took place outside of medical facilities. Type of participants: Victims of out-of-hospital cardiac arrest for whom the EMS system was activated by a 911 telephone request for emergency medical assistance. Measurements and main results: The cost, including training, personnel, equipment, and response time maintenance, per year of life saved was found to be $8,886.00 for paramedic care. This result was compared with published cost-effectiveness figures for heart transplantation, liver transplantation, bone marrow transplantation, and chemotherapy for acute leukemia. Paramedic care was more cost effective, as measured by cost per year of life saved, than organ transplantation and chemotherapy for acute leukemia. Conclusion: Out-of-hospital treatment by paramedics of cardiopulmonary arrest is more cost effective than heart, liver, bone marrow transplantation, or curative chemotherapy for acute leukemia. © 1990 American College of Emergency Physicians.