Cost-effectiveness of automated external defibrillators in public places: pro

Abstract

Placement of automated external defibrillators in public facilities is a cost-effective treatment for out-of-hospital cardiac arrests. This review describes the literature citing the benefits of early defibrillation, ease of use, and relative cost of automated external defibrillators. Placement of automated external defibrillators in public places was recommended by the American Heart Association in the early 1990s. Compared with waiting for traditional emergency medical services, immediate use of automated external defibrillators by laypersons can dramatically increase survival to hospital discharge rates. Placement of automated external defibrillators at locations such as casinos, airports, and airplanes that are frequented by large numbers of at-risk people is cost-effective compared with other economically acceptable health measures. Studies using simulations to predict numbers of quality-adjusted life years that would be gained from implementation of public access defibrillation programs in high-incidence locations find that the cost would be less than the typically acceptable $50 000 per quality-adjusted life year. The cost estimates, however, depend on the incidence of cardiac arrest at the sites, with low-incidence sites being prohibitively expensive. Automated external defibrillators appear to be cost-effective in locations with high incidences of cardiac arrest.