How many automated early defibrillators in which region? An economic decision model for the Austrian Red Cross

We developed an innovative decision model combined with an integer programming model to analyse the cost-effectiveness of semi-automated early defibrillators (AEDs) for the Austrian Red Cross. To estimate the costs of this intervention per quality-adjusted life-year (QALY) gained, we calculated the acquisition and maintenance costs of defibrillators, training costs for emergency medical technicians, hospitalisation costs for patients with sudden cardiac arrest and future health care costs for surviving patients discharged from a hospital as well as the improved survival and quality-of-life benefits from the use of AEDs. AED programmes produced cost-effectiveness ratios of less than 55,000 Euro per QALY over a wide range of assumptions regarding uncertain parameters in the analysis. The AED costs for a full AED programme would amount to a maximum of approximately 10.3 million Euro for the Red Cross. The first step would be to equip ambulances in rural areas, then in urban areas and finally in Vienna.