101. Increasing Cost-Effectiveness of AEDs using Algorithms to Optimize Location
Invited abstract in session TB-2: Advances in Health Economics and Healthcare Management, stream Regular talks.
Tuesday, 11:00-12:30Room: Room S1
Authors (first author is the speaker)
| 1. | Derya Demirtas
|
| Industrial Engineering & Business Information Systems, University of Twente | |
| 2. | Robin Buter
|
| Industrial Engineering & Business Information Systems, University of Twente | |
| 3. | Remy Stieglis
|
| Amsterdam UMC | |
| 4. | Hans van Schuppen
|
| Amsterdam UMC | |
| 5. | Erik Koffijberg
|
| h.koffijberg@utwente.nl |
Abstract
Volunteer responder systems aim to decrease time to defibrillation by dispatching trained volunteers to automated external defibrillators (AEDs) and out-of-hospital cardiac arrest (OHCA) victims. AEDs are often underutilized due to poor placement. This study provides a cost-effectiveness analysis of adding AEDs at (near-)optimal locations to maximize quality-adjusted life years (QALYs).
We simulated combined volunteer, police, firefighter, and EMS response scenarios to OHCAs, and applied our methods to a case study of Amsterdam, the Netherlands. We compared the competing strategies of placing additional AEDs, using steps of 40 extra AEDs (0, 40, …, 1480), in addition to the existing 369 AEDs. Incremental cost-effectiveness ratios (ICERs) were calculated for each increase in additional AEDs, using a societal perspective and life-time time horizon. The effect of AED connection and time to connection on survival to hospital admission and neurological outcome at discharge was estimated using logistic regression, using OHCA data from Amsterdam from 2006-2018.
Purchasing up to 1120 additional AEDs (ICER €75,669/QALY) was cost-effective at a willingness-to-pay threshold of €80,000/QALY, when positioned (near-)optimally. Compared to current practice, adding 1120 AEDs resulted in a gain of 0.111 QALYs (95% CI 0.110-0.112) at an increased cost of €3792 per OHCA (95% CI €3778-€3807). The findings advocate for a substantial increase in the number of AEDs.
Keywords
- Cost effectiveness and health economics
- Emergency Medical Service
- Optimization algorithms
Status: accepted
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