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.
| Original language | English |
|---|---|
| Pages (from-to) | 17 - 28 |
| Number of pages | 12 |
| Journal | Australian Journal of Rural Health |
| Volume | 32 |
| Issue number | 1 |
| Early online date | 2023 |
| DOIs | |
| Publication status | Published - Feb 2024 |
Bibliographical note
Funding Information:The research reported in this paper is a project of Menzies School of Health Research, Charles Darwin University, supported by funding through the Central Australia Academic Health Science Network and Central Australian Health Services. The information and opinions contained in it do not necessarily reflect the views or policies of the Central Australia Academic Health Science Network or Central Australian Health Services. The following authors report an affiliation with the NT Department of Health and/or Central Australian Health Service: Richard Johnson, David Reeve, Yuejen Zhao, Bridget Honan, Danielle Green and Petra Niclasen.
Publisher Copyright:
© 2023 The Authors. Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd.
