Data from: Hospital costs of out-of-hospital cardiac arrest patients treated in intensive care; a single centre evaluation using the national tariff-based system

Objectives: There is a scarcity of literature reporting hospital costs for
treating out of hospital cardiac arrest (OOHCA) survivors, especially
within the UK. This is essential for assessment of cost-effectiveness of
interventions necessary to allow just allocation of resources within the
National Health Service. We set out primarily to calculate costs
stratified against hospital survival and neurological outcomes.
Secondarily, we estimated cost effectiveness based on estimates of
survival and utility from previous studies to calculate costs per quality
adjusted life year (QALY). Setting: We performed a single centre (London)
retrospective review of in-hospital costs of patients admitted to the
intensive care unit (ICU) following return of spontaneous circulation
(ROSC) after OOHCA over 18 months from January 2011 (following widespread
introduction of targeted temperature management and primary percutaneous
intervention). Participants: Of 69 successive patients admitted over an
18-month period, survival and cerebral performance category (CPC) outcomes
were obtained from review of databases and clinical notes. The Trust
finance department supplied ICU and hospital costs using the Payment by
Results UK system. Results: Of those patients with ROSC admitted to ICU,
survival to hospital discharge (any CPC) was 33/69 (48%) with 26/33
survivors in CPC 1–2 at hospital discharge. Cost per survivor to hospital
discharge (including total cost of survivors and non-survivors) was
£50 000, cost per CPC 1–2 survivor was £65 000. Cost and length of stay of
CPC 1–2 patients was considerably lower than CPC 3–4 patients. The
majority of the costs (69%) related to intensive care. Estimated cost per
CPC 1–2 survivor per QALY was £16 000. Conclusions: The costs of
in-hospital patient care for ICU admissions following ROSC after OOHCA are
considerable but within a reasonable threshold when assessed from a QALY
perspective.