Russell, Deborah Jane

Zhao, Yuejen

Mathew, Supriya

Fitts, Michelle Susannah

Johnson, Richard

Reeve, David Mark

Honan, Bridget

Niclasen, Petra

Liddle, Zania

Green, Danielle

Wakerman, John

2023-11-02

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.

Menzies School of Health Research, Charles Darwin University, Alice Springs, Northern Territory, Australia.

Northern Territory Department of Health, Health Statistics and Informatics, Darwin, Northern Territory, Australia.

Northern Territory Health, Central Australian Health Service, The Gap, Northern Territory, Australia.

Aust J Rural Health . 2024 Feb;32(1):17-28. doi: 10.1111/ajr.13057. Epub 2023 Nov 2.

0000-0003-2221-7334

0000-0002-5775-4503

0000-0002-8078-3708

0000-0003-2839-5430

https://pubmed.ncbi.nlm.nih.gov/37916478/?otool=iaurydwlib

https://hdl.handle.net/10137/12634

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

Journal Article

Publication