A decision analytic approach to commissioning ambulance cardiac services

Robin Dowie (Health Economics Research Group, Brunel University, Uxbridge, Middlesex, UK)
Richard P.F. Gregory (Department of Biological Sciences, University of Manchester, Manchester, UK)
Kathleen V. Rowsell (South Lancashire Health Authority, Eccleston, Lancashire, UK)
Shân Annis (South Lancashire Health Authority, Eccleston, Lancashire, UK)
A.D. Gick (South Lancashire Health Authority, Eccleston, Lancashire, UK)
Christopher J. Harrison (North West Lancashire Health Authority, Wesham, Lancashire, UK)

Journal of Management in Medicine

ISSN: 0268-9235

Publication date: 1 April 1998


The paper discusses how a decision analytic framework has been used by an English health authority in relation to the commissioning of ambulance cardiac services. Strategies for the management by ambulance personnel of victims of cardiac arrest and persons with acute chest pain of cardiac origin were modelled in a decision‐event tree, and a bibliographic database established. The international research literature prior to 1997 was searched in order to derive probability values for the tree. However, after checking whether the sub‐groupings of results in the papers were in accordance with the variables in the tree, the number of useful papers on acute chest pain was found to be only two. In the almost complete absence of information ‐ even from small observational studies ‐ on the management of the great majority of patients with cardiac symptoms transported by ambulance, the local ambulance service and the main providers of hospital services in the district are now collaborating in field studies of cardiac care in order to improve the inputs into the model.



Dowie, R., Gregory, R., Rowsell, K., Annis, S., Gick, A. and Harrison, C. (1998), "A decision analytic approach to commissioning ambulance cardiac services", Journal of Management in Medicine, Vol. 12 No. 2, pp. 81-91. https://doi.org/10.1108/02689239810227100

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Copyright © 1998, MCB UP Limited

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