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Are We Measuring What Matters? Re-Examining National Out-of-Hospital Cardiac Arrest Outcome Indicators
Jason Belcher1,2, Stephen Ball1,2, Judith Finn1,2
1Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), Curtin University, Western Australia, Australia.
Emergency Medicine Australasia : EMA
|April 7, 2026
Summary
Current out-of-hospital cardiac arrest (OHCA) indicators in Australia should be updated. We propose using patient-centered outcomes like survival to hospital discharge for better benchmarking and international alignment.
Area of Science:
- Emergency Medicine
- Public Health
- Health Services Research
Background:
- The Australian Report on Government Services (ROGS) uses outdated outcome measures for out-of-hospital cardiac arrest (OHCA).
- Current indicators rely on return of spontaneous circulation (ROSC) at hospital arrival, unchanged since 2003.
- Australia's OHCA data infrastructure has significantly advanced since the indicators' inception.
Purpose of the Study:
- To propose updated OHCA indicators for Australian ambulance services.
- To enhance patient-centered outcomes and enable meaningful benchmarking.
- To align Australian reporting standards with international consensus.
Main Methods:
- Review of current ROGS OHCA indicators.
- Analysis of advancements in Australian OHCA data infrastructure.
- Comparison with international reporting standards and consensus recommendations.
Main Results:
- Current OHCA indicators lack patient-centered outcomes and international alignment.
- Survival to hospital discharge is the internationally recommended primary outcome.
- Recommended changes include incorporating witness status and stratifying paramedic-witnessed arrests.
Conclusions:
- Updating OHCA indicators is crucial for accurate benchmarking and patient focus.
- Implementing survival to discharge as the primary outcome aligns with global standards.
- Proposed changes are feasible given current data infrastructure and registries.
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