Abstract 19024: Cost Effective Adolescent Athlete Heart Screening Models
Introduction: Although sudden cardiac death (SCD) among adolescent athletes is rare, many of the conditions that lead to SCD may be identified with ECG and limited echo (LE) screening.
Hypothesis: Efficient models of screening using ECG and LE may be cost effective.
Methods: Using two models, 2506 adolescent athletes were screened: Model 1 all individuals (2021) underwent ECG and LE and Model 2 all students (485) underwent ECG and approximately 10% underwent LE at the discretion of the cardiologists on site. The incremental costs of screening events were determined by accounting for the cost for the services provided by all personnel and the supplies required in each model. This accounting did not include the costs of infrastructure, overhead and major equipment.
Results: The average cost per student in Model 1 was $56.42 per student based on an average event participation of 72 students (approximately half of maximal efficiency). With maximal attendance of 150 students per event the cost is approximately $27.07 per student. The actual cost of Model 2 was $20.33 per student however the hyothetical cost was $42.21 per student (when physician services were included). In aggregate, 14 students (0.56%) were found to have heart conditions associated with high risk for SCD (2 Hypertrophic Cardiomyopathy, 1 Left Ventricular non-compaction, 6 WPW, 4 Long QT syndrome, 1 sub-aortic stenosis). Model 1 generated 121 abnormal ECG's and 46 abnormal echocardiograms. Model 2 generated 27 abnormal ECGs. Assuming a life expectancy of 77.7 years and the average age of discovery of the high risk lesion at 14.4 years and the risk for sudden cardiac death with a high risk lesion at 0.5%, quality adjusted life years (QALY) was calculated for each model. In Model 1 the QALY is $32,087 ($15,367 with maximal participation) and in Model 2 the QALY is $24,006 ($11,562 actual).
Conclusion: Both screening models are cost effective if only incremental costs are considered and participation is maximized.
- © 2010 by American Heart Association, Inc.