The efficiency, timeliness, health outcomes and cost-effectiveness of a new aeromedical retrieval model in Central Australia: A pre- and post-implementation observational study

Deborah Jane Russell, Yuejen Zhao, Supriya Mathew, Michelle Susannah Fitts, Richard Johnson, David Mark Reeve, Bridget Honan, Petra Niclasen, Zania Liddle, Danielle Green, John Wakerman

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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 languageEnglish
Pages (from-to)1-12
Number of pages12
JournalAustralian Journal of Rural Health
Early online date2023
DOIs
Publication statusE-pub ahead of print - 2023

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