Every year, millions of people suffer from heart attack. In Central Europe alone, more than 600,000 cases of cardiac arrest occur annually – 9 per 10,000 inhabitants. Some are lucky to survive. Some don’t. Those who survived were probably recipients of intensive care.
A major heart attack entails that a patient be admitted to an intensive care unit (ICU). There are many other acute conditions aside from cardiac problems that require intensive care. Add to these a large number of trauma cases and ICUs can get very crowded indeed. ICUs however cost a lot of money and can be a burden to the health care system. The question always arises as to how to prioritize limited ICU space.
Should the spaces be given only to those with the highest likelihood of survival? Should seemingly hopeless cases, e.g. cases wherein medical treatment seems futile, be denied ICU access? There are no easy answers to these questions ethically and medically. However, in many cases, decisions on health care issues are based on cost-efficiency.
A study conducted by German researchers, however, indicates that acute cardiac cases are not necessary a waste of health care resources, that a heart attack is not necessarily a death sentence. The researchers tracked 354 patients who had cardiac arrest and admitted to the ICU from 1 January 1999 to 31 December 2001. All patients received cardiopulmonary resuscitation. 204 of the patients died at the hospital while 150 survived. Of the survivors, 110 patients (31% of all participants) lived 5 years or more after the heart attack. The health-related quality of life of these survivors was only slightly lower than controls of the same age and gender who never suffered from a heart attack. The total cost for the ICU treatment of all 354 participants was over 6.3 million Euros. The health care expenditure for each survivor was calculated to be 49,952 Euros.
The key findings of the study are:
- Patients who leave the hospital following cardiac arrest without severe neurological disabilities may expect fair long-term survival and a good quality of life.
- Costs per life year gained and costs per quality-adjusted life year in survivors after cardiac arrest are acceptable.
- Expenses to the health care system are reasonable compared with other interventions carried out in both intensive care unit (ICU) and non-ICU patients.
The study results show that money spent on cardiac patients is reasonable and well worth it. I think it’s more than that. I think that human life is priceless and everybody deserves the health care they need, regardless of the cost.
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