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
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to ResuscitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Regional variation in the characteristics, incidence and outcomes of out-of-hospital cardiac arrest in Australia and New Zealand: results from the Aus-ROC Epistry.Resuscitation. 2018; 126: 49-57
- Victorian ambulance cardiac arrest registry 2017/2018. Annual report.Ambulance Victoria, 2018
- 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC).Eur Heart J. 2015; 36: 2793-2867
- A prospective study of sudden cardiac death among children and young adults.N Engl J Med. 2016; 374: 2441-2452
- Care after REsuscitation: implementation of the United Kingdom’s first dedicated multidisciplinary follow-up program for survivors of out-of-hospital cardiac arrest.Ther Hypothermia Temp Manag. 2020; 10: 53-59
- One-year longitudinal study of psychological distress and self-assessed health in survivors of out-of-hospital cardiac arrest.BMJ Open. 2019; 9e029756
- Factors associated with return to work among survivors of out-of-hospital cardiac arrest.Resuscitation. 2020; 146: 203-212
- Productivity costs of cardiovascular disease mortality across disease types and socioeconomic groups.Open Heart. 2019; 6e000939
- Economic burden of cardiovascular diseases in the enlarged European Union.Eur Heart J. 2006; 27: 1610-1619
- Cost of cardiovascular diseases in the United Kingdom.Heart. 2006; 92: 1384-1389
- Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association.Circulation. 2011; 123: 933-944
- VACAR annual report 2018/2019.(Melbourne, Victoria)2019
- Using a cardiac arrest registry to measure the quality of emergency medical service care: decade of findings from the Victorian Ambulance Cardiac Arrest Registry.Circ Cardiovasc Qual Outcomes. 2015; 8: 56-66
- VACAR external data dictionary.2014
- Economic security - working population.(Canberra, Australia)2017
- Recurrent out-of-hospital cardiac arrest.Resuscitation. 2017; 121: 158-165
- Deaths in Australia: life expectancy (expected age at death in years) at different ages by sex, 1881–1890 to 2016–2018.(Canberra, Australia)2020
- Productivity burden of hypertension in Australia.Hypertension. 2019; 73: 777-784
- The productivity burden of diabetes at a population level.Diabetes Care. 2018; 41: 979-984
- 5204.0 Australian system of national accounts (Table 1).(Available from:)2018
- Guidelines for preparing submissions to the pharmaceutical benefits advisory committee. Version 5.Department of Health, 2017
- The End Unexplained Cardiac Death (EndUCD) registry for young Australian sudden cardiac arrest.Heart Lung Circ. 2021; 30: 714-720
- Cardiac sudden death in Italy. Dimensions, perceptions, policies and economic/financial impact.G Ital Cardiol (Rome). 2008; 9: 5s-23s
- Public health burden of sudden cardiac death in the United States.Circ Arrhythm Electrophysiol. 2014; 7: 212-217
- Victorian state budget 2019/2020.(Victoria, Australia)2019/20
- Budget 2019/20: investing in the health of Australians.(Canberra, Australia. Available from:)2019
- Cardiovascular health mission Canberra, Australia.(Available from:)2019
- Labour force participation and the cost of lost productivity due to cancer in Australia.BMC Public Health. 2018; 18: 375
- Out-of-hospital cardiac arrest attended by ambulance services in Ireland: first 2 years’ results from a nationwide registry.Emerg Med J. 2016; 33: 776-781
- Characterising risk of in-hospital mortality following cardiac arrest using machine learning: a retrospective international registry study.PLoS Med. 2018; 15e1002709
- Cardiac arrest and sudden cardiac death registries: a systematic review of global coverage.Open Heart. 2020; 7e001195
- Out-of-hospital cardiac arrests in young adults in Melbourne, Australia-adding coronial data to a cardiac arrest registry.Resuscitation. 2011; 82: 1302-1306
- Value of statistical life.Australian Government, Canberra, Australia2019
Article info
Publication history
Published online: April 15, 2021
Accepted:
April 1,
2021
Received in revised form:
February 15,
2021
Received:
November 29,
2020
Identification
Copyright
Crown Copyright © 2021 Published by Elsevier B.V. All rights reserved.
