Evaluating Public Programs To Save Lives

The Case of Heart Attacks

by Jan Paul Acton

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Analyzes public programs to reduce heart attack mortality. The analysis is structured for a decisionmaker who must make a program-funding decision for a community of 100,000 whose characteristics are similar to those of the metropolitan United States. Since the decisionmaker must work within a budget, this report identifies alternative programs that are economically viable and suggests measures of worth for evaluating the potential results of each program. A willingness-to-pay questionnaire is used as one basis for valuing the outcomes. The five programs analyzed in this report include (1) screening for high-risk persons and pretreating those whose ECGs show abnormalities; (2) ambulance with trained nonphysician personnel; (3) mobile coronary care unit with physician; (4) community triage center; and (5) triage center plus ambulance. Results of the cost-effectiveness and cost-benefit analysis are given. The report concludes that evaluation of lifesaving programs can be approached systematically and preferences of citizens can be incorporated into the evaluation.

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