Cost-Effectiveness of the Implantable Cardiac Defibrillator. Abstract, Appendix,Executive Summary, and Final Report

摘要

This study was intended to estimate the effect of the implantable cardiacdefibrillator (ICD) on survival following an initial heart attack, cost of medical care, patient cognitive function and psychological status. This study cohort included all persons (n=117) enrolled in an ICD clinical trial in Baltimore during 1983-84, compared with a cohort (n=91) of comparable patients treated in Seattle (where the ICD was not in use) during the same period. Subjects were followed until death or December 31, 1990. Results showed that the ICD effected a 37% increase in survival at a cost increased by 93%. Prospective data collected on the ICD patients only indicated no negative effects on cognitive or other psychological measures. Cost-effectiveness calculations indicated that the ICD fell at that time well within the range of other common life-saving interventions, with technological advances likely to improve this ratio still further.