The efficiency, timeliness, health outcomes and cost-effectiveness of a new aeromedical retrieval model in Central Australia: A pre- and post-implementation observational study.
The Australian journal of rural health · 2023-11-02 · Observational study
Abstract
OBJECTIVE: To assess timeliness, efficiency, health outcomes and cost-effectiveness of the 2018 redesigned Central Australian aeromedical retrieval model. DESIGN: Pre- and postimplementation observational study of all patients receiving telehealth consultations from remote medical practitioners (RMPs) or Medical Retrieval and Consultation Centre (MRaCC) physicians between 1/1/2015 and 29/2/2020. Descriptive and inferential statistics measuring system efficiency, timeliness, health outcomes and incremental cost-effectiveness. FINDINGS: There were 9%-10% reductions in rates of total aeromedical retrievals, emergency department admissions and hospitalisations postimplementation, all p-values < 0.001. Usage rates for total hospital bed days and ICU hours were 17% lower (both p < 0.001). After adjusting for periodicity (12% fewer retrievals on weekends), each postimplementation year, there were 0.7 fewer retrievals/day (p = 0.002). The mean time from initial consultation to aeromedical departure declined by 18 minutes post-implementation (115 vs. 97 min, p = 0.007). The hazard of death within 365 days was nonsignificant (0.912, 95% CI 0.743-1.120). Postimplementation, it cost $302 more per hospital admission and $3051 more per year of life saved, with a 75% probability of cost-effectiveness. These costs excluded estimated savings of $744,528/year in reduced hospitalisations and the substantial social and out-of-pocket costs to patients and their families associated with temporary relocation to Alice Springs. CONCLUSION: Central Australia's new critical care consultant-led aeromedical retrieval model is more efficient, is dispatched faster and is more cost-effective. These findings are highly relevant to other remote regions in Australia and internationally that have comparable GP-led retrieval services.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Helicopter & air ambulance · Cost & cost-effectiveness · Mortality & survival · Prehospital physicians · Rural & remote · Telemedicine · Time intervals
Related articles
- Evaluation of a new medical retrieval and primary health care advice model in Central Australia: Results of pre- and post-implementation surveys. (Aust J Rural Health, 2023)
- Comparative Study on the Outcome of Trauma Patients Transferred by Doctor Helicopters and Ground Ambulance in South Korea. (Disaster Med Public Health Prep, 2022)
- Comparison of physician-staffed helicopter with ground-based emergency medical services for trauma patients. (Am J Emerg Med, 2021)
- A scenario based approach to optimizing cost-effectiveness of physician-staffed Helicopter Emergency Medical Services compared to ground-based Emergency Medical Services in Finland. (Scand J Trauma Resusc Emerg Med, 2024)
- [Is a tele-emergency physician system a sensible addition in rural German regions?-An analysis from a medical and economic perspective]. (Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz, 2022)
- Adopting the pre-hospital index for interfacility helicopter transport: a proposal. (Injury, 2003)