A systematic review of cost‐effectiveness of treating out of hospital cardiac arrest and the implications for resource‐limited health systems
Dublin Core
Title
A systematic review of cost‐effectiveness of treating out of hospital cardiac arrest and the implications for resource‐limited health systems
Subject
Emergency care, Cardiac arrest, Cost-effectiveness, Health policy, Health economics, Public health
Description
Abstract
Background Out-of-hospital cardiac arrest (OHCA) is a prevalent condition with high mortality and poor outcomes
even in settings where extensive emergency care resources are available. Interventions to address OHCA have had
limited success, with survival rates below 10% in national samples of high-income countries. In resource-limited
settings, where scarcity requires careful priority setting, more data is needed to determine the optimal allocation
of resources.
Objective To establish the cost-effectiveness of OHCA care and assess the affordability of interventions
across income settings.
Methods The authors conducted a systematic review of economic evaluations on interventions to address OHCA.
Six databases (PubMed, EMBASE, Global Health, Cochrane, Global Index Medicus, and Tuft’s Cost-Effectiveness
Registry) were searched in September 2023. Included studies were (1) economic evaluations (beyond a simple cost-
ing exercise); and (2) assessed an intervention in the chain of survival for OHCA. Article quality was assessed using
the CHEERs checklist and data summarised. Findings were reported by major themes identified by the reviewers.
Based upon the results of the cost-effectiveness analyses we then conduct an analysis for the progressive realization
of the OHCA chain of survival from the perspective of decision-makers facing resource constraints.
Results Four hundred and sixty-eight unique articles were screened, and 46 articles were included for final data
abstraction. Studies predominantly used a healthcare sector perspective, modeled for all patients experiencing non-
traumatic cardiac OHCA, were based in the US, and presented results in US Dollars. No studies reported results or used
model inputs from low-income settings. Progressive realization of the chain of survival could likely begin with invest-
ments in termination of resuscitation protocols, professional prehospital defibrillator use, and CPR training followed
by the distribution of AEDs in high-density public locations. Finally, other interventions such as indiscriminate defibril-
lator placement or adrenaline use, would be the lowest priority for early investment.
Conclusion Our review found no high-quality evidence on the cost-effectiveness of treating OHCA in low-resource
settings. Existing evidence can be utilized to develop a roadmap for the development of a cost-effective approach
Background Out-of-hospital cardiac arrest (OHCA) is a prevalent condition with high mortality and poor outcomes
even in settings where extensive emergency care resources are available. Interventions to address OHCA have had
limited success, with survival rates below 10% in national samples of high-income countries. In resource-limited
settings, where scarcity requires careful priority setting, more data is needed to determine the optimal allocation
of resources.
Objective To establish the cost-effectiveness of OHCA care and assess the affordability of interventions
across income settings.
Methods The authors conducted a systematic review of economic evaluations on interventions to address OHCA.
Six databases (PubMed, EMBASE, Global Health, Cochrane, Global Index Medicus, and Tuft’s Cost-Effectiveness
Registry) were searched in September 2023. Included studies were (1) economic evaluations (beyond a simple cost-
ing exercise); and (2) assessed an intervention in the chain of survival for OHCA. Article quality was assessed using
the CHEERs checklist and data summarised. Findings were reported by major themes identified by the reviewers.
Based upon the results of the cost-effectiveness analyses we then conduct an analysis for the progressive realization
of the OHCA chain of survival from the perspective of decision-makers facing resource constraints.
Results Four hundred and sixty-eight unique articles were screened, and 46 articles were included for final data
abstraction. Studies predominantly used a healthcare sector perspective, modeled for all patients experiencing non-
traumatic cardiac OHCA, were based in the US, and presented results in US Dollars. No studies reported results or used
model inputs from low-income settings. Progressive realization of the chain of survival could likely begin with invest-
ments in termination of resuscitation protocols, professional prehospital defibrillator use, and CPR training followed
by the distribution of AEDs in high-density public locations. Finally, other interventions such as indiscriminate defibril-
lator placement or adrenaline use, would be the lowest priority for early investment.
Conclusion Our review found no high-quality evidence on the cost-effectiveness of treating OHCA in low-resource
settings. Existing evidence can be utilized to develop a roadmap for the development of a cost-effective approach
Creator
Kalin Werner1,2*, Sarah Hirner3
, O. Agatha Offorjebe4
, Edouard Hosten5
, Julian Gordon6
, Heike Geduld7
,
Lee A. Wallis1 and Nicholas Risko8
, O. Agatha Offorjebe4
, Edouard Hosten5
, Julian Gordon6
, Heike Geduld7
,
Lee A. Wallis1 and Nicholas Risko8
Source
https://doi.org/10.1186/s12245-024-00727-w
Date
2024
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Kalin Werner1,2*, Sarah Hirner3
, O. Agatha Offorjebe4
, Edouard Hosten5
, Julian Gordon6
, Heike Geduld7
,
Lee A. Wallis1 and Nicholas Risko8, “A systematic review of cost‐effectiveness of treating out of hospital cardiac arrest and the implications for resource‐limited health systems,” Repository Horizon University Indonesia, accessed April 25, 2026, https://repository.horizon.ac.id/items/show/12452.