Health and economical consequences of programmes to reduce the delay in the thrombolytic therapy of patients with acute myocardial infarction

Danish Centre for Evaluation and Health Technology Assessment
Record ID 32002000824
Danish
Authors' objectives:

The aim of this study was to develop a model to evaluate health and cost consequences of programmes aimed to reduce the delay of thrombolytic therapy to Danish AMI-patients.

Authors' results and conclusions: Based on the estimates, which are most likely to be true (base case estimates), the telemedicine strategy will lead to seven additional cases of AMI surviving the first month after admission to hospital, while a public campaign will lead to about five additional survivors each year. With between 12 and 13 additional survivors of AMI in relation to the situation with the actual delay, the combination of the two programmes will have a minor synergetic effect. The result should be seen in relation to fact that 240 of 1000 cases of AMI died during the first month after admission in 1996. If the telemedicine approach is used 239 patients out of 1000 cases of AMI is expected to die during the first month after admission. With a time horizon of five years and adopting the perspective of the health care provider, a public campaign will cost 283.000 DKK per life year gained, while the telemedicine strategy will cost about 1.3 million DKK per life year gained (discounting at 5% p.a.). The combination of the two strategies will total 842.700 DKK per life year gained. Marginally the telemedicine approach costs about 1.2 million DKK per incremental life year gained. In the sensitivity analysis the extent to which the results of the analysis were sensitive to other estimates of the parameters was analysed. It is estimated that the public campaign will cost between 170.400 DKK and 621.200 DKK per life year gained, while the telemedicine strategy will cost between 719.000 DKK and 3.219.000 DKK per life year gained.
Authors' recomendations: Both programmes are likely to result in limited health outcomes, partly explained by the fact that in spite of the programmes few patients will be treated within the first two hours. Reducing the Danish delay in thrombolytic therapy of AMI-patients by a general introduction of the telemedicine approach will be very resource consuming pr. life year gained. The resources required are more than the Society normally is willing to accept. The public campaign will be about five fold less expensive pr. life year gained than the telemedicine strategy. Whether a public campaign should be conducted in Denmark cannot only be concluded from the present analysis.
Authors' methods: Review
Details
Project Status: Completed
URL for project: http://www.sst.dk/
Year Published: 2001
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Denmark
MeSH Terms
  • Costs and Cost Analysis
  • Health Promotion
  • Program Evaluation
  • Telemedicine
  • Thrombolytic Therapy
  • Myocardial Infarction
Contact
Organisation Name: Danish Centre for Evaluation and Health Technology Assessment
Contact Address: National Board of Health, PO Box 1881, Islands Brygge 67, DK-2300 Copenhagen S, Denmark. Tel: 45 72 22 74 48; Fax: 45 72 22 74 07/67
Contact Name: dacehta@sst.dk
Contact Email: dacehta@sst.dk
Copyright: Danish Centre for Evaluation and Health Technology Assessment (DACEHTA) (formerly DIHTA)
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