2) Now, suppose the government is considering creating mobile coronary care unit
ID: 126242 • Letter: 2
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2) Now, suppose the government is considering creating mobile coronary care units. A mobile coronary care unit is an emergency vehicle with equipment and trained personnel for monitoring the victims and providing emergency treatment for heart attacks. It is intended to reduce mortality prior to hospitalization, the period when half of the heart attack deaths occur. Ok, lets look at the costs of staffing and equipping one of these units. Lets put that at $500,000 which would include 25,000 people. Now, this would allow it to intervene in an average of 20 cases of heart attacks a year. Lets put the average heart attack at age 50 Currently, half of those suffering a MI (heart attack) die (no, its not that high, simple numbers here). Lets say they would have otherwise lived to 80. Now, this mobile unit would decrease the rate to just 40% (ie prevent 20% of those who would have died from dying). Now, the cost of treating Ml is currently S20,000 and the cost of treating in the a year. Let us further assume that it covers a territory mobile unit would be $25,000 (on top of its operating costs) What is the cost-benefit analysis here? Iflooking at cost effectiveness, what about instead spending money ona program to encourage people to keep a closer eye on blood pressure and deal with high blood pressure. When might you decide to fund one program over the other?Explanation / Answer
Scenario:
Cost of staffing and equipping one mobile coronary care unit is $500,000.
One unit covers 25,000 people in a community and manages at least 20 cases per year.
The average age of heart attack is 50 years of age and 50% of the population die from it. If prevented, they live for 80 years of age. That is out of 20 cases, 10 cases die from heart attack.
This unit decreases the risk of heart attack by 40% of the 50% population [10 cases] or 20% of the total population [20 cases] who has the possibility of death due to a heart attack. That is out of 10 cases who die as a result of heart attack, 40% or 4 people are prevented from death.
Cost of treating an MI patient at a hospital is $20,000.
Cost of providing care and treating an MI patient in the mobile unit is $25,000.
Calculating the cost incurred:
Cost of budgeting one mobile coronary care unit is 500,000.
Cost of treating an MI patient at a hospital is $20,000.
Cost of providing care and treating an MI patient in the mobile unit is $25,000.
A single unit manages at least 20 cases per year among which 50% or 10 cases would be prevented from death related to heart attack and out of these 10 cases [who die as a result of heart attack], 40% or 4 people are prevented from death.
Cost of treating all MI patients [20 people] [prevent from death] at a hospital is $20,000 x 20 = $400,000.
Cost of treating all MI patients [20 people] [prevent from death] in the mobile unit is $25,000 x 20 = $500,000.
That is the total cost associated for preventing death of patients is with managing MI patients in a 25,000 people community is:
Mobile unit initial cost + cost of treatment at mobile unit for 10 people and cost of treatment at hospital for 10 people
Total cost = $500,000 + $400,000 + $500,000 = $1,400,000
Calculating the benefit obtained:
The total benefit it yields is preventing 4 cardiac risk patients from dying.
Therefore,
The total cost associated per person from heart attack-related death is 1,400,000/4 = $350,000
This amount spent benefits approx 10 people from getting death at least for 30 years [from prevents death from 50 years to 80 years]
Cost associated with managing an MI patient per year is 350,000/30 = $11,667
It is evident the cost incurred per person for managing heart attack through this mobile coronary unit and preventing death is 11667 per person per year which is quite a significant cost compared to the total benefit it provides [preventing death for per year for 30 years].
It is also clearly noted that this cost does not eradicate or prevent the disease rather it is meant only for early diagnosis and treatment.
Therefore, in my opinion, rather than implementing this plan, we can prefer other cost-effective or cost-cutting strategy for the prevention of cardiac-related deaths by means of other effective methods like
Compared to the cost incurred with these prevention methods the mobile unit which offer early detection and treatment is less effective and hence it should not be recommended for implementation.
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