Volume 7, Issue 1 (3-2023)
EBHPME 2023, 7(1): 51-58 |
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Pakdaman M, Askari R, Dehghan A, Pahlavanpoor S, Nikafshan A. Evaluation of the Consequences and Costs of the Anglo-American System in the Pre-Hospital Emergency Department of Yazd in 2018. EBHPME 2023; 7 (1) :51-58
URL: http://jebhpme.ssu.ac.ir/article-1-415-en.html
URL: http://jebhpme.ssu.ac.ir/article-1-415-en.html
Health Policy and Management Research Center, Department of Health Management and Economics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran , Nikanjan115@gmail.com
Abstract: (379 Views)
Background: One of the most important tasks of health care managers is allocateing resources, controling them and ensuring their effective use when available. This study examines the consequences and costs of emergency services in Yazd in 2018.
Methods: This was a descriptive-analytical study performed on patients of 11 centers in Yazd in 2018. The population of the city was approximately 750,000 in 2018 (1). Direct and indirect costs were extracted, and the consequences and costs of Yazd emergency in 2018 were calculated in riyal and Dollars.
Results: This study showed that in 2018, out of 173154 contacts, 37988 cases led to the dispatch of an ambulance, and the response rate was 18 %. The rate of hospitalization was 52 %. The average time of dispatch in Yazd pre-hospital emergency department was (10:48) in 2018. Of the 59 high-risk patients who were transported to Yazd's pre-hospital emergency in 2018, 5 patients had successful cardiopulmonary resuscitation(discharge from the hospital). In other words, effectiveness and saving people from death was 8.4 %. Depreciation costs in the pre-hospital emergency department of Yazd in 2018 amounted to 65,061 Dollars (9,759,264,923 Rial). The cost of personnel salaries and benefits was 39669829 Dollars ( 59504743663 Rial). This amount was about 40 % of the total cost of the year for pre-hospital emergency in Yazd city. The average cost of each mission-dispatch was 25 Dollars (3775967 Rial).
Conclusion: This study examines the consequences and costs of per hospital emergency department in Yazd in 2018. The high number of unnecessary calls to Yazd emergency department calls for the need to raise public awareness. Moreover, the lack of need to transfer half of these people to hospital requires training and retraining of telephone triage nurses.
Methods: This was a descriptive-analytical study performed on patients of 11 centers in Yazd in 2018. The population of the city was approximately 750,000 in 2018 (1). Direct and indirect costs were extracted, and the consequences and costs of Yazd emergency in 2018 were calculated in riyal and Dollars.
Results: This study showed that in 2018, out of 173154 contacts, 37988 cases led to the dispatch of an ambulance, and the response rate was 18 %. The rate of hospitalization was 52 %. The average time of dispatch in Yazd pre-hospital emergency department was (10:48) in 2018. Of the 59 high-risk patients who were transported to Yazd's pre-hospital emergency in 2018, 5 patients had successful cardiopulmonary resuscitation(discharge from the hospital). In other words, effectiveness and saving people from death was 8.4 %. Depreciation costs in the pre-hospital emergency department of Yazd in 2018 amounted to 65,061 Dollars (9,759,264,923 Rial). The cost of personnel salaries and benefits was 39669829 Dollars ( 59504743663 Rial). This amount was about 40 % of the total cost of the year for pre-hospital emergency in Yazd city. The average cost of each mission-dispatch was 25 Dollars (3775967 Rial).
Conclusion: This study examines the consequences and costs of per hospital emergency department in Yazd in 2018. The high number of unnecessary calls to Yazd emergency department calls for the need to raise public awareness. Moreover, the lack of need to transfer half of these people to hospital requires training and retraining of telephone triage nurses.
Type of Study: Original article |
Subject:
General
Received: 2022/12/25 | Accepted: 2023/03/28 | Published: 2023/03/30
Received: 2022/12/25 | Accepted: 2023/03/28 | Published: 2023/03/30
References
1. Isna. The latest statistics of the population of Yazd province and cities. 2018. Available from URL: https://www.isna.ir/news. Last access: May 10, 2022.
2. Landman AB, Lee ChH, Sasson C, Van Gelder CM, Curry LA. Prehospital electronic patient care report systems: Early experiences from emergency medical services agency leaders. PLoS One. 2012; 7(3): e32692. [DOI: 10.1371/journal.pone.0032692]
3. Abuzeyad F, Alqasem L, Al Farras MI, Al Jawder ShS, Al Qasim Gh, Alghanem s. Emergency medicine in the Kingdom of Bahrain. International Journal of Emergency Medicine. 2018; 11(1): 4. [DOI: 10.1186/s12245-018-0163-1]
4. Moghimi R, Anvari A. An integrated fuzzy MCDM approach and analysis to evaluate the financial performance of Iranian cement companies. The International Journal of Advanced Manufacturing Technology. 2014; 71(1-4): 685-98. [DOI: 10.1007/s00170-013-5370-6]
5. Kordestani Gh, Bakhtiari M, Biglari V. Ability of combinations of cash flow components to predict financial distress. Business: Theory and practice. 2011; 12(3): 277-85. [DOI: 10.3846/btp.2011.28]
6. Law J, Vanderploeg J. An emergency medical planning guide for commercial spaceflight events. Aviat Space Environ Med. 2012; 83(9): 890-5. [DOI: 10.3357/asem.3345.2012]
7. Edlin G, Golanty E. Health and wellness. Jones & Bartlett Publishers; 2021.
8. Saberinia A, Aminizadeh M, Valy L, Mahmoudi Maimand F. Report on the experience and performance of emergency medical personnel in 2019. 2012. Available from URL: https://sid.ir/paper/816574/fa. Last access: May 7, 2022. [In Persian]
9. Definition of the word from the Oxford dictionary. Available from URL: https://www. oxfordlearnersdictionaries. com/. Last access: July 10, 2022.
10. Zakariah A, Stewart BT, Boateng E, Achena Ch, Tansley G, Mock Ch. The birth and growth of the national ambulance service in Ghana. Prehosp Disaster Med. 2017; 32(1): 83-93. [DOI: 10.1017/S1049023X16001151]
11. de Anda HH, Moy HP. EMS Ground Transport Safety. Available from URL: https://pubmed.ncbi.nlm. nih.gov/32644397/. Last access: May 15, 2022.
12. Bahrami MA, Maleki A, Ranjbar Ezzatabadi M, Askari R, Ahmadi Tehrani GH. Pre-hospital Emergency Medical Services in developing countries: A case study about EMS response time in Yazd, Iran. Iranian Red Crescent Medical Journal. 2011; 13(10): 735-8.
13. Bahadori MK, Ravangard R. Determining and prioritizing the organizational determinants of Emergency Medical Services (EMS) in Iran. Iranian Red Crescent Medical Journal. 2013; 15(4): 307-11. [DOI: 10.5812/ircmj.2192]
14. Stiell IG, Wells GA, Field BJ, Spaite DW, Maio VJD, Ward R, et al. Improved out-of-hospital cardiac arrest survival through the inexpensive optimization of an existing defibrillation program: OPALS study phase II. Ontario Prehospital Advanced Life Support. JAMA. 1999; 281(13): 1175-81. [DOI: 10.1001/jama.281.13.1175]
15. Al-Shaqsi S. Models of international Emergency Medical Service (EMS) systems. Oman Medical Journal. 2010; 25(4): 320-3. [DOI: 10.5001/omj. 2010.92]
16. Al-Shaqsi SZK. EMS in the sultanate of Oman. Resuscitation. 2009; 80(7): 740-2. [DOI: 10.1016/ j.resuscitation.2009.04.011]
17. Williams B. Management of Emergency Demand. Ambulance Services. 2015; 43-50.
18. Dick WF. Anglo-American vs. Franco-German Emergency Medical Services system. Prehosp Disaster Med. 2003; 18(1): 29-35. [DOI: 10.1017/s1049023x00000650]
19. Dib JE, Naderi S, Sheridan IA, Alagappan K. Analysis and applicability of the Dutch EMS system into countries developing EMS systems. The Journal of Emergency Medicine. 2006; 30(1): 111-5. [DOI: 10.1016/j.jemermed.2005.05.014]
20. Rodigin A. An update on emergency care and emergency medicine in Russia. International journal of emergency medicine. 2015; 8: 42. [DOI: 10.1186/s12245-015-0092-1]
21. Cottrell EK, O'Brien k, Curry M, Meckler GD, Engle PP, Jui J, et al. Understanding safety in prehospital emergency medical services for children. Prehosp Emerg Care. 2014; 18(3): 350-8. [DOI: 10.3109/10903127.2013.869640]
22. Hoyt RE, Yoshihashi AK. Health informatics: Practical guide for healthcare and information technology professionals. 6nd ed. Science & Medicine: 2014. p. 533.
23. Zia N, Shahzad H, Baqir SM, Shaukat, Sh, Ahmad H, Robinson C, et al. Ambulance use in Pakistan: An analysis of surveillance data from emergency departments in Pakistan. BMC Emergency Medicine. 2015; 15(Suppl 2): S9.
24. Xu H, Xian Y, Woon FP, Bettger JP, Laskowitz DT, Ng YY, et al. Emergency medical services use and its association with acute ischaemic stroke evaluation and treatment in Singapore. Stroke and Vascular Neurology. 2020; 5(2): 121-7. [DOI: 10.1136/svn-2019-000277]
25. Wilson MH, Habig K, Wright Ch, Hughes A, Davies G, Imray ChHE. Pre-hospital emergency medicine. Lancet. 2015; 386(10012): 2526-34. [DOI: 10.1016/S0140-6736(15)00985-X]
26. von Vopelius-Feldt J, Powell J, Morris R, Benger J. Prehospital critical care for out-of-hospital cardiac arrest: An observational study examining survival and a stakeholder-focused cost analysis. BMC Emerg Med. 2016; 16(1): 47. [DOI: 10.1186/s12873-016-0109-y]
27. Timm A, Maegele M, Lefering R, Wendt K, Wyen H. Pre-hospital rescue times and actions in severe trauma. A comparison between two trauma systems: Germany and the Netherlands. Injury. 2014; 45(Suppl 3): S43-S52. [DOI: 10.1016/j.injury.2014.08.017]
28. Shah MN. The formation of the emergency medical services system. American Journal of Public Health. 2006; 96(3): 414-23. [DOI: 10.2105/AJPH.2004.048793]
29. Strobel ChE, Karpinski E, Levy AM, Davison S. A Modified EMS System: Transport Ambulance. 2016.
30. Owusu-Ansah S, Moore B, Shah MI, Gross T, Brown K, Gausche-Hill M, et al. Pediatric readiness in emergency medical services systems. Pediatrics. 2020; 145(1): e20193308. [: 10.1542/peds.2019-3308]
31. Kahn Ch. Commentary: Making a difference in emergency medical services. Annals of Emergency Medicine. 2011; 57(2): 169-71. [DOI: 10.1016/j.annemergmed.2010.11.010]
32. Patterson PD, Jones ChB, Hubble MW, Carr M, Weaver MD, Engberg J, et al. The longitudinal study of turnover and the cost of turnover in emergency medical services. Prehosp Emerg Care. 2010; 14(2): 209-21. [DOI: 10.3109/10903120903564514]
33. Lerner EB, Nichol G, Spaite DW, Garrison HG, Maio RF. A comprehensive framework for determining the cost of an emergency medical services system. Ann Emerg Med. 2007; 49(3): 304-13. [DOI: 10.1016/j.annemergmed.2006.09.019]
34. Moghaddasi H, Rabiei R, Mastaneh Z. Pre-hospital emergency information system in America and England: A review. Payesh. 2014; 13(4): 383-91. [In Persian]
35. Byrne JP, Mann NC, Dai M, Mason SA, Karanicolas P, Rizoli S, et al. Association between emergency medical service response time and motor vehicle crash mortality in the United States. JAMA Surg. 2019; 154(4): 286-93. [DOI: 10.1001/ jamasurg. 2018.5097]
36. Altintas KH, Bilir N. Ambulance times of Ankara emergency aid and rescue services’ ambulance system. European Journal of Emergency Medicine. 2001; 8(1): 43-50. [DOI: 10.1097/00063110-200103000-00009]
37. Moradian MJ, Peyravi MR, Ettehadi R, Pourmohammadi K. Studying the time of response and results of delay in emergency medical system. Quarterly Scientific Journal of Rescue and Relief. 2013; 5(2): 30-9. [In Persian]
38. Nasiripur AA, Bahadori MK, Tofighiet Sh, Gohari MR. Prehospital emergency performance in Iran View of comprehensive coverage plan. Journal of Critical Care Nursing. 2010; 2(4): 3-4. [In Persian]
39. Nichol G, Detsky AS, Stiell IG, Rourke KO, Wells G, Laupacis A. Effectiveness of emergency medical services for victims of out-of-hospital cardiac arrest: A metaanalysis. Annals of Emergency Medicine. 1996; 27(6): 700-10. [DOI: 10.1016/s0196-0644(96)70187-7]
40. Peralta LMP. The prehospital emergency care system in Mexico City: A system's performance evaluation. Prehospital and Disaster Medicine. 2006; 21(2): 104-11. [DOI: 10.1017/s1049023x00003447]
41. Dadashzadeh A, Dehghannejhad J, Shams S, Sadegi H, Hassanzadeh F, Soheili A, et al. Situation of response and transport time in pre-hospital traumatic patients from scene to hospital in Tabriz–Iran. Nursing and Midwifery Journal. 2016; 14(8): 728-37. [In Persian]
42. Al-Shaqsi SZKh. Response time as a sole performance indicator in EMS: Pitfalls and solutions. Open Access Emergency Medicine: OAEM. 2010; 2: 1.
43. Sefrin P, Kuhnigk H. The position of the emergency physician in the emergency medical service. Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS. 2006; 41(1): 2-8. [DOI: 10.1055/s-2006-924965]
44. Dib J, Naderi S, Sheridan IA, Alagappan K. Analysis and applicability of the Dutch EMS system into countries developing EMS systems. The Journal of Emergency Medicine. 2006; 30(1): 111-5. [DOI: 10.1016/j.jemermed.2005.05.014]
45. Ebrahimi Pour H, Pourahmadi E, Vafayinezhad R, Badie Aval Sh. Total cost of pre-hospital emergency missions based on the activity-based costing model and its comparison with the cost of private emergency pre-hospital emergency services in Mashhad in 2016. Quarterly Journal of Management Strategies in Health System. 2019; 4(2): 86-96. [DOI: 10.18502/mshsj.v4i2.1405]
46. Newgard CD, Yang Zh, Nishijima D, McConnell KJ, Trent SA, Holmes JF, et al. Cost-effectiveness of field trauma triage among injured adults served by emergency medical services. Journal of the American College of Surgeons. 2016; 222(6): 1125-37. [DOI: 10.1016/j.jamcollsurg.2016.02.014]
47. Valenzuela TD, Criss EA, Spaite D, Meislin HW, Wright AL, Clark L. Cost-effectiveness analysis of paramedic emergency medical services in the treatment of prehospital cardiopulmonary arrest. Ann Emerg Med. 1990; 19(12): 1407-11. [DOI: 10.1016/S0196-0644(05)82609-5]
48. Langabeer JR, Champagne-Langabeer T, Alqusairi D, Kim J, Jackson A, Persse D, et al. Cost-benefit analysis of telehealth in pre-hospital care. J Telemed Telecare. 2017; 23(8): 747-51. [DOI: 10.1177/ 1357633X16680541]
49. Lee MH, Schuur JD, Zink BJ. Owning the Cost of Emergency Medicine: Beyond 2 %. Annals of Emergency Medicine. 2013; 62(5): 498-505. [DOI: 10.1016/j.annemergmed.2013.03.029]
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