Shell Health, Shell International B.V., Carel van Bylandtlaan 16, 2596HR The Hague, The Netherlands.
Aberdeen Centre for Trauma Research, Faculty of Health and Social Care, Robert Gordon University, Aberdeen, UK.
J Travel Med. 2017 May 1;24(3). doi: 10.1093/jtm/taw095.
Businesses increasingly conduct operations in remote areas where medical evacuation [Medevac(s)] carries more risk. Royal Dutch Shell developed a remote healthcare strategy whereby enhanced remote healthcare is made available to the patient through use of telemedicine and telemetry. To evaluate that strategy, a review of Medevacs of Shell International employees [i.e. expatriate employees (EEs) and frequent business travellers (FBTs)] was undertaken.
A retrospective review of Medevac data (period 2008-12) that were similar in operational constraints and population profile was conducted. Employee records and Human Resource data were used as a denominator for the population. Analogous Medevac data from specific locations were used to compare patterns of diagnoses.
A total of 130 Medevacs were conducted during the study period, resulting in a Medevac rate of 4 per 1000 of population with 16 per 1000 for females and 3 per 1000 for males, respectively. The youngest and oldest age-groups required Medevacs in larger proportions. The evacuation rates were highest for countries classified as 'high' or 'extreme risk'. The most frequent diagnostic categories for Medevac were: trauma, digestive, musculoskeletal, cardiac and neurological. In 9% of the total, a strong to moderate link could be made between the pre-existing medical condition and diagnosis leading to Medevac.
This study uniquely provides a benchmark Medevac rate (4 per 1000) for EEs and FBTs and demonstrates that Medevac rates are highest from countries identified as 'high risk'; there is an age and gender bias, and pre-existing medical conditions are of notable relevance. It confirms a change in the trend from injury to illness as a reason for Medevac in the oil and gas industry and demonstrates that diagnoses of a digestive and traumatic nature are the most frequent. A holistic approach to health (as opposed to a predominant focus on fitness to work), more attention to female travellers, and the application of modern technology and communication will reduce the need for Medevacs.
企业越来越多地在偏远地区开展业务，这些地区的医疗后送（Medevac）风险更大。荷兰皇家壳牌公司制定了一项远程医疗策略，通过使用远程医疗和远程遥测技术为患者提供增强的远程医疗服务。为了评估该策略，对壳牌国际员工（即外派员工（EEs）和经常出差的商务旅行者（FBTs））的 Medevac 进行了回顾。
对 2008-12 年期间具有类似运营限制和人口特征的 Medevac 数据进行了回顾性审查。员工记录和人力资源数据被用作人口的分母。使用特定地点的类似 Medevac 数据来比较诊断模式。
在研究期间共进行了 130 次 Medevac，每千人中有 4 人需要 Medevac，女性为每千人 16 人，男性为每千人 3 人。年龄最小和最大的年龄组需要 Medevac 的比例更大。风险被归类为“高”或“极高”的国家的撤离率最高。Medevac 最常见的诊断类别是：创伤、消化系统、肌肉骨骼、心脏和神经。在总人数的 9%中，可以在预先存在的医疗状况和导致 Medevac 的诊断之间建立强有力的联系。
这项研究独特地为 EE 和 FBT 提供了一个基准的 Medevac 率（每千人 4 人），并表明 Medevac 率最高的国家被识别为“高风险”；存在年龄和性别偏见，预先存在的医疗条件具有重要意义。它证实了在石油和天然气行业，Medevac 的原因从受伤转向疾病的趋势发生了变化，并表明消化系统和创伤性疾病的诊断最为常见。健康的整体方法（而不是主要关注工作能力）、更多关注女性旅行者以及现代技术和通信的应用将减少 Medevac 的需求。
