Economic and Societal Impact of a Systems-of-Care Approach for STEMI Management in Low and Middle-Income Countries: Insights from the TN STEMI Program

Ann Glob Health. 2019 Oct 15;85(1):122. doi: 10.5334/aogh.2508.

Abstract

The TN STEMI Program was a multicenter, prospective, observational study conducted in Tamil Nadu, India, that assessed the effects of implementing the STEMI India Model for the management of STEMI. We discuss the economic and societal impact in this article. Given that the intervention resulted in an absolute mortality reduction of 3.4%, we calculated a number needed to treat of 30 patients. At an annualized project cost of INR 15.11 million, this approximately calculates to INR 193,749 (USD 3,311) per life saved. The utility of the TN-STEMI Program can be estimated to be 1,108 life-years. This calculates to approximately INR 13,643 (USD 233) per life-year saved. Our estimates will likely be of particular interest to policy makers in low and middle-income countries, where financial and resource constraints pose a perennial public health challenge.

Publication types

  • Observational Study

MeSH terms

  • Coronary Angiography*
  • Cost-Benefit Analysis
  • Delivery of Health Care / economics
  • Delivery of Health Care / organization & administration*
  • Efficiency
  • Health Care Costs*
  • Health Services Accessibility
  • Humans
  • Implementation Science
  • India / epidemiology
  • Interrupted Time Series Analysis
  • Numbers Needed To Treat
  • Percutaneous Coronary Intervention*
  • Prospective Studies
  • Quality Improvement
  • ST Elevation Myocardial Infarction / diagnosis
  • ST Elevation Myocardial Infarction / economics
  • ST Elevation Myocardial Infarction / mortality
  • ST Elevation Myocardial Infarction / therapy*
  • Systems Analysis
  • Thrombolytic Therapy*
  • Time-to-Treatment
  • Workforce