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The economic impact of sudden cardiac arrest

  • Elizabeth D. Paratz
    Correspondence
    Corresponding author at: Baker Heart and Diabetes Institute, 75 Commercial Rd, Prahran, VIC, 3181, Australia.
    Affiliations
    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
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  • Karen Smith
    Affiliations
    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
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  • Jocasta Ball
    Affiliations
    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
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  • Alexander van Heusden
    Affiliations
    Baker Heart and Diabetes Institute, 75 Commercial Rd, Prahran, VIC, 3181, Australia
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  • Dominica Zentner
    Affiliations
    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
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  • Sarah Parsons
    Affiliations
    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
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  • Natalie Morgan
    Affiliations
    Victorian Institute of Forensic Medicine, 65 Kavanagh St, Southbank, VIC, 3006, Australia
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  • Tina Thompson
    Affiliations
    Royal Melbourne Hospital, 300 Grattan St, Parkville, VIC, 3050, Australia
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  • Paul James
    Affiliations
    Royal Melbourne Hospital, 300 Grattan St, Parkville, VIC, 3050, Australia
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  • Andreas Pflaumer
    Affiliations
    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
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  • Christopher Semsarian
    Affiliations
    Agnes Ginges Centre for Molecular Cardiology at Centenary Institute, The University of Sydney, The University of Sydney, Missenden Rd, Sydney, NSW, 2050, Australia
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  • Dion Stub
    Affiliations
    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
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  • Author Footnotes
    1 Denotes equal senior authors.
    Danny Liew
    Footnotes
    1 Denotes equal senior authors.
    Affiliations
    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
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  • Author Footnotes
    1 Denotes equal senior authors.
    Andre La Gerche
    Footnotes
    1 Denotes equal senior authors.
    Affiliations
    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
    Search for articles by this author
  • Author Footnotes
    1 Denotes equal senior authors.

      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

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