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. 2016 Nov 21;16(1):229.
doi: 10.1186/s12872-016-0414-0.

Cost-effectiveness of workplace wellness to prevent cardiovascular events among U.S. firefighters

P Daniel Patterson  1 , Kenneth J Smith  2 , David Hostler  3
Affiliations

Cost-effectiveness of workplace wellness to prevent cardiovascular events among U.S. firefighters

P Daniel Patterson et al. BMC Cardiovasc Disord. .

Abstract

Background: The leading cause of death among firefighters in the United States (U.S.) is cardiovascular events (CVEs) such as sudden cardiac arrest and myocardial infarction. This study compared the cost-effectiveness of three strategies to prevent CVEs among firefighters.

Methods: We used a cost-effectiveness analysis model with published observational and clinical data, and cost quotes for physiologic monitoring devices to determine the cost-effectiveness of three CVE prevention strategies. We adopted the fire department administrator perspective and varied parameter estimates in one-way and two-way sensitivity analyses.

Results: A wellness-fitness program prevented 10% of CVEs, for an event rate of 0.9% at $1440 over 10-years, or an incremental cost-effectiveness ratio of $1.44 million per CVE prevented compared to no program. In one-way sensitivity analyses, monitoring was favored if costs were < $116/year. In two-way sensitivity analyses, monitoring was not favored if cost was ≥ $399/year. A wellness-fitness program was not favored if its preventive relative risk was >0.928.

Conclusions: Wellness-fitness programs may be a cost-effective solution to preventing CVE among firefighters compared to real-time physiologic monitoring or doing nothing.

Keywords: Cardiovascular events; Cost-Effectiveness; Physical fitness; Wellness.

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Figures

Fig. 1
Fig. 1
Decision Tree. Figure 1 Notes/Legend: Schematic representation of the decision analysis model. Brackets indicate that the subsequent node will be attached to all prior branches of the decision tree
Fig. 2
Fig. 2
Sensitivity Analysis. Figure 2 Notes/Legend: Sensitivity analysis, varying the relative risk of CVEs with a wellness/fitness program (the x-axis of each graph), the relative risk with a monitor (the y-axis of each graph), the initial monitor cost (columns of graphs), and the yearly monitor maintenance cost as a percentage of the initial cost (rows of graphs). Shaded areas within each graph depict favored strategies when the willingness to pay is $2,000,000 per CVE avoided over a 10-year time horizon
See this image and copyright information in PMC

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