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[远程急诊医生系统在德国农村地区是合理的补充吗?——从医学和经济角度的分析]

[Is a tele-emergency physician system a sensible addition in rural German regions?-An analysis from a medical and economic perspective].

作者信息

Brinkrolf Peter, Kuntosch Julia, Metelmann Bibiana, Metelmann Camilla, Hahnenkamp Klaus, Süss Rebekka, Hasebrook Joachim Paul, Fleßa Steffen

机构信息

Klinik für Anästhesie, Intensiv‑, Notfall- und Schmerzmedizin, Universitätsmedizin Greifswald, Greifswald, Deutschland.

Lehrstuhl für Allgemeine Betriebswirtschaftslehre und Gesundheitsmanagement, Rechts- und Staatswissenschaftliche Fakultät, Universität Greifswald, Friedrich-Loeffler-Str. 70, 17489, Greifswald, Deutschland.

出版信息

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2022 Oct;65(10):1007-1015. doi: 10.1007/s00103-022-03581-4. Epub 2022 Sep 9.

Abstract

BACKGROUND AND OBJECTIVES

In 2017, a tele-emergency-physician system was implemented in the county of Vorpommern-Greifswald (Germany) to optimise the prehospital emergency medical service and to counteract current challenges. It was evaluated from a medical and economic perspective whether a tele-emergency physician system is a useful addition to the existing prehospital emergency system, especially in rural regions.

MATERIALS AND METHODS

Approximately 250,000 emergency medical service data from the years 2015 to 2020 (before and after the implementation of the telemedical system) were analysed in a pre-post comparison. A total of 3611 tele-emergency physician cases were analysed regarding medical indication and time-related factors. Additionally, total costs of the tele-emergency physician system as well as a cost analysis regarding prehospital and hospital medical costs of selected diseases were performed.

RESULTS

The tele-emergency physician treated patients of all age groups with a wide spectrum of diseases. Of the cases, 48.2% were moderate to severe but not life-threatening disorders. Patients as well as emergency medical service personnel embraced the new system. According to the data, ambulances that were equipped with the telemedical system had the number of missions requiring an emergency physician on scene reduced significantly by 20%. The yearly costs of this telemedical system amount to €1.7 million.

CONCLUSIONS

The tele-emergency physician system proved to be a telemedical innovation that is medically advisable, functional and cost-efficient. Therefore, the tele-emergency physician system continued to operate after the end of the research project and is ready to be implemented across Germany.

摘要

背景与目的

2017年,德国前波美拉尼亚-格雷夫斯瓦尔德县实施了远程急救医生系统,以优化院前急救医疗服务并应对当前挑战。从医学和经济角度评估了远程急救医生系统是否是现有院前急救系统的有益补充,特别是在农村地区。

材料与方法

在前后对比中分析了2015年至2020年(远程医疗系统实施前后)约25万份急救医疗服务数据。对总共3611例远程急救医生病例的医疗指征和时间相关因素进行了分析。此外,还计算了远程急救医生系统的总成本以及对选定疾病的院前和医院医疗费用进行了成本分析。

结果

远程急救医生治疗了所有年龄组患有多种疾病的患者。其中,48.2%为中度至重度但无生命危险的疾病。患者和急救医疗服务人员都接受了新系统。根据数据,配备远程医疗系统的救护车需要急诊医生到现场的任务数量显著减少了20%。该远程医疗系统的年度成本为170万欧元。

结论

远程急救医生系统被证明是一项在医学上可行、功能良好且具有成本效益的远程医疗创新。因此,远程急救医生系统在研究项目结束后继续运行,并准备在德国各地实施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a23/9522693/1ce4322bac2e/103_2022_3581_Fig1_HTML.jpg

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