Estimated cost effectiveness of a police automated external defibrillator program in a suburban community: 7 years experience

Objective: To estimate the cost effectiveness of a 7-year police automatic external defibrillator (AED) program in four suburban communities. Method: 10-year retrospective study (7/89-7/99) of patients of four suburban communities during two study periods: (1) police first response and advanced life support (ALS) care (No-AED) and; (2) AED equipped police first response (P-AED) with subsequent ALS care. Using the perspective of the communities, we obtained costs of AED program from police agencies. We estimated cost/life saved and cost/year lives saved using decreased time to VF shock by EMS. We performed a sensitivity analysis for estimates of potential benefit using estimated improved survival as a result of decreased EMS response interval and obtained survival data. We used literature-based estimates of life expectancy after cardiac arrest survival to estimate cost/year life saved. We used student's t-test and chi(2) to estimate differences between groups. Results: During the 10-year study period 208 patients met study criteria; (81 No-AED, 128 P-AED). The two groups were not different by patient age, ALS response interval, percent in VF, percent witnessed (WIT), or arrest location. Interval to first defibrillator equipped EMS vehicle arrival was less in the P-AED group (2.0 vs. 5.4 min, P < 0.001) as was the interval from the emergency (911) call to first VF shock (6.6 vs. 8.4 min, P = 0.02). Survival to DC was not statistically different with P-AED (11.9 vs. 9.9%, P = 0.66) but this study was not powered to detect a difference. Estimated cost per life saved with P-AED varied from $23 542 to $70 342 and cost per year life saved ranged from $1582 to $16 060. Conclusion: Police AED appears to be a cost-effective intervention in these suburban communities which have relatively rapid EMS response intervals. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.