Royal Flying Doctor Service, Canberra, Australia; National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia; The Australian National University Medical School, The Australian National University, Canberra, Australia.
Menzies Institute for Medical Research, The University of Tasmania, Hobart, Tasmania.
Air Med J. 2020 Sep-Oct;39(5):343-350. doi: 10.1016/j.amj.2020.06.010. Epub 2020 Jul 15.
Adequate mental health service provision in rural and remote Australian communities is problematic because of the tyranny of distance. The Royal Flying Doctor Service provides air medical retrieval for people in rural and remote areas. The economic impact on both the Royal Flying Doctor Service and the public hospital system for mental health-related air medical retrievals is unknown. We aimed to estimate the direct medical costs associated with air medical retrievals and subsequent hospitalizations for mental and behavioral disorders for the 2017 calendar year.
All patients with a primary working diagnosis of International Statistical Classification of Diseases and Related Health Problems, 10th Version, Australian Modification F00 to F99 (mental and behavioral disorders) who underwent an air medical retrieval were included in this cost analysis. International Statistical Classification of Diseases and Related Health Problems, 10th Edition, Australian Modification codes were mapped to Australian Refined Diagnosis Related Group codes, with hospital costs applied from the National Hospital Cost Data Collection (2016/2017). All costs are reported in 2017 Australian dollars (AUDs).
One hundred twenty-two primary evacuations and 926 interhospital transfers occurred with an in-flight diagnosis of F00 to F99, most commonly psychotic disorders, including schizophrenia and schizotypal disorders. The total direct medical costs were estimated to be AUD $20,070,527. Costs for primary evacuations accounted for 13% (AUD $2,611,260), with the majority of this associated with the subsequent hospital admission (AUD $1,770,139). Similarly, the majority of the costs associated with interhospital transfers (total costs = AUD $17,459,267) were also related to hospital costs (AUD $13,569,187).
Direct medical costs associated with air medical retrievals for people experiencing a mental health crisis are substantial. The majority of costs are associated with hospital admission and treatment; however, the indirect (loss of productivity) and intangible (quality of life) costs are likely to be far greater.
由于距离的限制，澳大利亚农村和偏远地区的心理健康服务提供存在问题。皇家飞行医生服务为农村和偏远地区的人们提供航空医疗救援。对于与心理健康相关的航空医疗救援，皇家飞行医生服务和公共医院系统的经济影响尚不清楚。我们旨在估算 2017 年日历年度与航空医疗救援以及随后因精神和行为障碍住院相关的直接医疗费用。
所有主要诊断为国际疾病分类和相关健康问题，第 10 版，澳大利亚修正 F00 至 F99（精神和行为障碍）的患者均纳入本成本分析。国际疾病分类和相关健康问题，第 10 版，澳大利亚修正代码被映射到澳大利亚细化诊断相关组代码，应用于国家医院成本数据收集（2016/2017）的医院成本。所有成本均以 2017 年澳元（AUD）报告。
有 122 次原发性疏散和 926 次院内转院，飞行中诊断为 F00 至 F99，最常见的是精神病，包括精神分裂症和精神分裂症样障碍。总直接医疗费用估计为 20070527 澳元。原发性疏散的费用占 13%（2611260 澳元），其中大部分与随后的住院有关（1770139 澳元）。同样，院内转院的大部分费用（总费用=26759267 澳元）也与医院费用有关（13569187 澳元）。
航空医疗救援人员因心理健康危机而产生的直接医疗费用巨大。大多数费用与住院治疗有关；然而，间接（生产力损失）和无形（生活质量）成本可能要高得多。
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