Are We Measuring What Matters? Re‐Examining National Out‐of‐Hospital Cardiac Arrest Outcome Indicators

The Australian Government Productivity Commission Report on Government Services (ROGS) includes three out-of-hospital cardiac arrest (OHCA) indicators within its ambulance services chapter, all using return of spontaneous circulation (ROSC) at hospital arrival as the outcome measure. This outcome definition has remained unchanged since its introduction in 2003, despite significant maturation of Australia's OHCA data infrastructure. We propose the current indicators be changed to reflect patient-centred outcomes, enable meaningful benchmarking and align with international standards. Specifically, we suggest that survival to hospital discharge (or 30 days), the outcome recommended by international consensus, should be the primary outcome measure; that the shockable rhythm indicator should incorporate witness status to align with the international reporting standard; and that paramedic-witnessed arrest reporting should be stratified by initial rhythm. With all Australian ambulance services now maintaining OHCA registries and contributing to the Australasian Resuscitation Outcomes Consortium Epistry, our recommended changes to the reporting are achievable.