Early neurologically focused follow-up after cardiac arrest is cost-effective: a trial-based economic evaluation
Open accessAbstract
Objective To evaluate the cost-effectiveness of an early intervention service for cardiac arrest survivors called 'Stand still …, and move on' from a societal perspective.Intervention This concise nursing intervention consists of screening for cognitive and emotional problems, information provision and support, self-management promotion, and further referral if necessary. Earlier research confirmed the feasibility of the intervention and its effectiveness in improving emotional functioning and quality of life.Methods In this multicentre randomized controlled trial with one year follow-up 185 patients were included between April 2007 and December 2010. The experimental group received the intervention, the control group received care-as-usual. Intervention costs, other direct healthcare costs (e.g. hospital care, rehabilitation, medication, home care) and indirect costs (productivity loss) were measured during ten months using monthly cost-diaries. The economic evaluation comprised a cost-utility analysis (SF-36) and a cost-effectiveness analysis (QOLIBRI) using bootstrapping (5000 replications) to quantify uncertainty concerning the incremental cost effectiveness ratio (ICER), and the probability of the intervention being cost-effective was estimated. To check the robustness of the findings, two sensitivity analyses were performed using the EQ-5D and the complete cases respectively.Results Of 136 (74%) participants sufficient data concerning costs were collected to be included in this economic evaluation. Intervention costs were on average €127 (SD 85). No significant differences between groups were found with regard to overall costs. The ICERs of the cost-utility and the cost-effectiveness analyses supported the cost-effectiveness of the intervention. The probability of the intervention being cost-effective was 54-76% for the SF-36 and 94% for the QOLIBRI. Findings were robust.Conclusion The intervention 'Stand still …, and move on' has positive societal economic effects and has a high probability to be cost-effective. Implementation in regular healthcare is recommended.Trial registration ISRCTN74835019.
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Observational data suggest that females and individuals from socially deprived and ethnic minority groups are less likely to receive bystander CPR and key post-arrest interventions.
“Observational data suggest that females and individuals from socially deprived and ethnic minority groups are less likely to receive bystander CPR and key post-arrest interventions. 295,296”
From European Resuscitation Council Guidelines 2021: Ethics of resuscitation and end of life decisions (2021) · cites this paper as [296]
Table 1 (page unavailable) records bystander CPR and participants’ sex, but compares trial arms rather than CPR receipt by sex, deprivation, or ethnicity. The Participants section (page unavailable) notes that women were more likely to drop out of this follow-up study; it does not address access to bystander CPR or post-arrest interventions. Searches for social deprivation, ethnic minority status, and disparities in CPR or intervention receipt found no passage addressing the claim. (LLM, conf=0.76)
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References 31 · Cited by 44
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- Authors
- Moulaert, V. R. M., Goossens, M., Heijnders, I. L. C., Verbunt, J. A., & Heugten, C. M. V.
- Affiliations
- Maastricht University (NL)
- De Hoogstraat Revalidatie (NL)
- Corresponding author
- Moulaert, Véronique R.M.
- Venue
- Resuscitation
- Publisher
- Elsevier BV
- Published
- 2016-09
- Volume
- 106
- Pages
- 30-36
- ISSN
- 0300-9572 (ISSN-L)
- OpenAlex
- W2469006914
- Semantic Scholar
- afb4dbca2407f21bf0b2d28347f6064126881c57
- Cited by
- 44
- References
- 31
- Citations by year
- 2026: 1 · 2025: 8 · 2024: 4 · 2023: 1 · 2022: 2 · 2021: 11 · 2020: 2 · 2019: 3 · 2018: 5 · 2017: 4 · 2016: 1 · 2015: 2
- FWCI
- 8.43
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Resuscitation (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, other-oa)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Funders
- ZonMw (ZonMw 920-03-373, 920-03-373)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Emergency Medicine › Cardiac Arrest and Resuscitation
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- cardiac arrest survivors, cost-effectiveness, nursing interventions, quality of life, productivity loss, health care costs
- MeSH terms
- Aged, Cost-Benefit Analysis, Female, Follow-Up Studies, Heart Arrest, Humans, Male, Middle Aged, Quality of Life, Surveys and Questionnaires, Health Care Costs, Cognitive Dysfunction
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