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从德国和美国医疗保健视角出发,利用慕尼黑啤酒节数据对重大活动现场计算机断层扫描进行的经济评估

Economic Evaluation of On-Site Computed Tomography at Major Events Using Data from the Munich Oktoberfest-A German and U.S. Healthcare Perspective.

作者信息

Flatz Wilhelm, Bogner-Flatz Viktoria, Hinzmann Dominik, Jeffrey Bazarian J, Ricke Jens, Karl-Georg Kanz, Kunz Wolfgang G, Mehrens Dirk

机构信息

Department of Radiology, LMU University Hospital, LMU Munich, 81377 Munich, Germany.

Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, 81377 Munich, Germany.

出版信息

J Clin Med. 2025 Mar 30;14(7):2375. doi: 10.3390/jcm14072375.

Abstract

: The Munich Oktoberfest is the largest Volksfest in the world, attracting more than 6 million visitors every year to the city of Munich and surroundings, posing challenges to healthcare providers. Since 2022, a CT has been installed on the festival site to decrease patient transport to emergency departments (EDs) and relieve EDs of a significant number of patients. The aim of our studies was to determine the economic impact of on-site CT on the healthcare system, both from a German and a U.S. perspective. : A decision model was built using patient data from the Munich Oktoberfest. Two scenarios were investigated where patients with mild traumatic brain injuries were either scanned for intracranial hemorrhage (ICH) with CT on-site or brought directly to an ED for further investigation. Costs for patient transportation and CT scans were derived from German national reimbursement rates as well as U.S. Medicare data. Costs were calculated by diagnosis in the national currency. : In all scenarios, on-site CT scans were associated with reduced costs per patient (EUR 243 vs. EUR 908 in the German setting and EUR 438 vs. EUR 1635 in the international setting, as well as USD 160 vs. USD 403 in the U.S. setting). For the U.S. scenario, the proportion of ICH in the patient group, as well as the transport distance, had the strongest impact on average costs per patient. : On-site CT scanning is a cost-reducing as well as clinically beneficial method for triaging patients at the Munich Oktoberfest.

摘要

慕尼黑啤酒节是世界上最大的民间节日,每年吸引超过600万游客前往慕尼黑市及其周边地区,这给医疗服务提供者带来了挑战。自2022年以来,节日现场安装了一台CT扫描仪,以减少患者转运至急诊科的情况,并减轻急诊科大量患者的负担。我们研究的目的是从德国和美国的角度确定现场CT对医疗系统的经济影响。

使用来自慕尼黑啤酒节的患者数据建立了一个决策模型。研究了两种情景,即轻度创伤性脑损伤患者要么在现场用CT扫描颅内出血(ICH),要么直接送往急诊科进行进一步检查。患者运输和CT扫描的费用来自德国国家报销率以及美国医疗保险数据。费用按国家货币的诊断计算。

在所有情景中,现场CT扫描均与每位患者成本降低相关(在德国情景中为243欧元对908欧元,在国际情景中为438欧元对1635欧元,在美国情景中为160美元对403美元)。对于美国情景,患者组中ICH的比例以及运输距离对每位患者的平均成本影响最大。

现场CT扫描是慕尼黑啤酒节对患者进行分流的一种降低成本且具有临床益处的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2f5/11989514/b7628604d5e4/jcm-14-02375-g001.jpg

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