Survival rates for cardiac arrests outside of the hospital have changed very little in the past 30 years despite increased health spending, recent University of Michigan research linking data from around the nation showed.

According to the study, the city where a person lives could play a big role in whether that person survives a cardiac arrest.

For instance, Detroit has the worst rate of survival among cities examined around the nation with .2 percent of those who have cardiac arrest outside the hospital surviving the episode. In comparison, 16.3 percent of those who go into cardiac arrest outside of the hospital in the Seattle area survive. The average national survival rate is 7.6 percent.

A big difference between Seattle and Detroit is largely the rate that bystanders step in and perform CPR, said Comilla Sasson, an emergency medicine physician at U-M and lead author of the study. Seattle’s rate of bystander CPR is more than 50 percent while the national average is closer to 1 in 3 people receiving bystander CPR.

Other factors determining cardiac arrest survival included whether or not a person had a shockable heart rhythm. The lack of progress could be linked to an aging population, lower number of people with the shockable heart rhythm or longer EMS drives because of growing cities or traffic congestion, the study found.

The biggest determining factor for survival appeared to be whether or not a heartbeat was restored at the scene with 15.5 percent survival in low-performing EMS systems and 33.6 percent in high-performing EMS symptoms surviving.

These findings support the idea that EMS crews should stay and attempt to restore a pulse on the scene where they have extra support rather than following the “scoop and go” model of restoring a pulse in the back of a speeding ambulance, Sasson said.

“What we’re trying to say is there are things we can do in our communities — in Detroit, in Ann Arbor — to improve our survival rates without expensive technology,” Sasson said.

See a video on how to perform CPR from the American Heart Association.

Some of those measures could include increased numbers of those who understand CPR recommendations, 911 dispatchers trained in explaining CPR over the telephone and increased awareness of where automated external defibrillators, or AEDs, are located, she said.

U-M boasts nearly 400 'Best Doctors'

Nearly 400 University of Michigan Health System physicians were recognized on a list of “Best Doctors in America,” the health system announced on Monday.

The list is compiled every two years by Best Doctors Inc. and is based on a survey of 45,000 physicians in 43 specialties and more than 400 subspecialties in medicine.

There are more than 1,600 faculty physicians treat patients in the U-M health system and several hundred others who are affiliated with the health system.

Study supports program for increasing medication adherence

Pharmacy-based interventions can help patients with serious mental illnesses stick to their regular medication regimens, U-M researchers found recently.

The study examined a particular pharmacy-based intervention program called MedsHelp in which pharmacy staff members were the contacts for patient questions regarding pharmacy services or doctor prescriptions. After a year, those patients who were enrolled in MedsHelp filled their medications 86 percent of the time, compared to 62 percent of patients receiving usual care, U-M said in a release.

The study of 118 patients in four VA facilities with either schizophrenia or bipolar disorder was published online in the Schizophrenia Bulletin.

“Because 40 percent of patients with schizophrenia and bipolar disorder have difficulty taking their medications regularly, we need to develop low cost, practical and non-coercive ways to help them become more adherent,” said lead researcher Marcia Valenstein, senior research scientist in the Veterans Administration Health Services Research and Development Service and U-M Medical School psychiatry professor.

Tina Reed covers health and the environment for AnnArbor.com. You can reach her at tinareed@annarbor.com, call her at 734-623-2535 or find her on Twitter @TreedinAA.