The economic impact of sudden cardiac arrest

Elizabeth D Paratz; Karen Smith; Jocasta Ball; Alexander van Heusden; Dominica Zentner; Sarah Parsons; Natalie Morgan; Tina Thompson; Paul James; Andreas Pflaumer; Christopher Semsarian; Dion Stub; Danny Liew; Andre La Gerche

doi:10.1016/j.resuscitation.2021.04.001

The economic impact of sudden cardiac arrest

Resuscitation. 2021 Apr 15:163:49-56. doi: 10.1016/j.resuscitation.2021.04.001. Online ahead of print.

Authors

Affiliations

¹ Baker Heart and Diabetes Institute, 75 Commercial Rd, Prahran, VIC, 3181, Australia; Alfred Hospital, 55 Commercial Rd, Prahran, VIC, 3181, Australia; St Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy, VIC, 3065, Australia. Electronic address: eparatz@hotmail.com.
² Ambulance Victoria, 375 Manningham Rd, Doncaster, VIC, 3108, Australia; Department of Paramedicine, Monash University, Melbourne, VIC, Australia; Department of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne 3004, Australia.
³ Baker Heart and Diabetes Institute, 75 Commercial Rd, Prahran, VIC, 3181, Australia; Ambulance Victoria, 375 Manningham Rd, Doncaster, VIC, 3108, Australia; Department of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne 3004, Australia.
⁴ Baker Heart and Diabetes Institute, 75 Commercial Rd, Prahran, VIC, 3181, Australia.
⁵ Royal Melbourne Hospital, 300 Grattan St, Parkville, VIC, 3050, Australia; Royal Melbourne Hospital Clinical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, 3000, Australia.
⁶ Victorian Institute of Forensic Medicine, 65 Kavanagh St, Southbank, VIC, 3006, Australia; Department of Forensic Medicine, Monash University, 65 Kavanagh St, Southbank, VIC, 3006, Australia.
⁷ Victorian Institute of Forensic Medicine, 65 Kavanagh St, Southbank, VIC, 3006, Australia.
⁸ Royal Melbourne Hospital, 300 Grattan St, Parkville, VIC, 3050, Australia.
⁹ Royal Children's Hospital, 50 Flemington Rd Parkville, Melbourne, VIC, 3052, Australia; Department of Paediatrics, Melbourne University, Parkville, VIC, 3010, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Flemington Rd, Parkville, VIC, 3052, Australia.
¹⁰ Agnes Ginges Centre for Molecular Cardiology at Centenary Institute, The University of Sydney, The University of Sydney, Missenden Rd, Sydney, NSW, 2050, Australia.
¹¹ Baker Heart and Diabetes Institute, 75 Commercial Rd, Prahran, VIC, 3181, Australia; Alfred Hospital, 55 Commercial Rd, Prahran, VIC, 3181, Australia; Ambulance Victoria, 375 Manningham Rd, Doncaster, VIC, 3108, Australia; Department of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne 3004, Australia.
¹² Alfred Hospital, 55 Commercial Rd, Prahran, VIC, 3181, Australia; Department of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne 3004, Australia.
¹³ Baker Heart and Diabetes Institute, 75 Commercial Rd, Prahran, VIC, 3181, Australia; Alfred Hospital, 55 Commercial Rd, Prahran, VIC, 3181, Australia; St Vincent's Hospital Melbourne, 41 Victoria Pde, Fitzroy, VIC, 3065, Australia.

PMID: 33865963
DOI: 10.1016/j.resuscitation.2021.04.001

Abstract

Background: There are 20,000 sudden cardiac arrests (SCAs) in Australia annually, with 90% case-fatality.

Objective: The present study calculated both the health and economic impact of SCAs in Victoria, Australia.

Methods: Data on all SCAs attended by Ambulance Victoria from July 2017 to June 2018 were collected regarding age, gender, and survival to hospital, discharge and 12 months. Pre-SCA employment status of all patients was modelled using age and gender-matched Australian economic data. A Markov state-transition model with a five-year horizon calculated health and economic impact in years of life lived (YLL), productivity-adjusted life years (PALYs) and gross domestic product (GDP) lost. A counterfactual Markov state-transition model assessed outcomes of an identical cohort of patients who did not experience SCA. All values were discounted by 5%.

Results: In 12 months, 4637 people suffered SCAs in Victoria, of whom 1516 (32.7%) were working at the time. 695 patients (15.0%) survived to hospital, 325 (7.0%) to discharge, and 303 (6.5%) to 12 months. In five years following their SCA, the cohort lost 15,922 years of life and 2327 PALYs. Reduced productivity led to GDP losses of AUD$448 million (92.8% relative reduction). Extrapolated to the 20,000 SCAs occurring across all of Australia, total GDP losses approached AUD$2 billion.

Conclusion: The health and economic burden of SCAs is high, predominantly underpinned by very high mortality. Annual national losses approach AUD$2 billion (USD$1.42 billion) and are comparable to productivity losses from all cancers combined. Prioritising research and state-of-the-art care for SCA patients appears economically sound.

Keywords: Economic analysis; Epidemiology; Productivity; Sudden cardiac arrest.