The Development and Trend of International Aeromedical Transport in Taiwan—A Retrospective Analysis between 2009 and 2012

• Main Authors: Ho-Hsiang Chen, 陳和庠
• Other Authors: Yueh-Chih Chen
• Format: Others
• Language: zh-TW
• Online Access: http://ndltd.ncl.edu.tw/handle/ez5h2k

碩士 === 弘光科技大學 === 護理研究所 === 102 === Background：People in Taiwan have the best benefit of national health insurance with cheapest cost and high quality in the world. Once encountering medical emergency in overseas, they should seek international aeromedical transport to bring patient back, not only due to barrier in the language, but also the convenience of care, and huge expensive of medical cost. However, experts of medical aviation care are few in Domestic. The situation and need of the market are therefore necessary for further evaluation and investigation. Objective：The purposes of this study are: (1) to understand the current status of the International aeromedical transport; (2) to analyze the trend of International aeromedical transport in period of 2009-2012; (3) to investigate the impact of relevant factors of international aeromedical transfer modes. Methods and materials：This study is a retrospective design of purposive sampling. Data of transferred cases, recorded by the team of central executive of international aeromedical transport during 4 years from January 2009 to December 2012, are collected and analyzed retrospectively using quantitative research method. The update of international medical transport in recent years is descriptive in this study. The chi-square test is used to signify the important factors affecting international aeromedical transport. Results：A total of 339 transferred cases are recruited. The average of age is 57.6 years old. The range of age is 1 m to 93 years old. Taiwanese patient is the most population of 82.0% (278/339). The average of flying distance and flight time is 1901.89 km (the range is 322 Km to 15792 Km) and 3.2 hours (the range is 80 mins to 1260 mins), respectively. Eighty six percent of patient is accompanied by flight nurse specialist care during transferring process. (1) The ratio of man to woman is 248:91, 73.2% and 26.8%, respectively. The rates of diseases diagnosed in order are cerebrovascular disease 38.3% (130/339), traumatic accidents 20.4% (69/339), and cardiovascular diseases 14.7% (50/339). The rate of respirator in use is 24.2% (82/339). According to mode of transportation, patients transferred by scheduled flights of civil aircraft are accounted for 81.7% (277/339), in which 106 people boarding by wheelchair and 171 people by stretcher. The use of charter flight is 4.4% (15/339), the air ambulance for 13.9% (47/339). Cases paid by there insurance companies that 54.3% (184 /339) , and by their own expense are 45.7% (155/339). The motivation of patient going abroad shows that 43.1% (146/339) for business and jobs, 27.1% (92/339) for tourism, 15.3% (52/339) for long-term residence, and 11.2% (38/339) for visiting friends or relatives. Transferee from mainland China is accounted for 63.4% of the total (215/339). The rate of reasons for the aeromedical transport due to inconvenience of medical care and medical needs of the emergencies are 48.1% (163/339) and 37.8% (128/339), respectively. Patients using oxygen are 55.5% (188/339), antihypertensive drug 13.3% (45/339), and agents used in hypotension or shock are 15.3% (52/339). Analysis of the distribution of hospital that received the patient in cases of Taiwan shows 40.5% (113/279) in northern medical center, 17.6% (49/279) in central medical centers, 14.3% (40/279)the northern regional teaching hospitals accounted, and 11.8% (33/279) in southern medical centers. (2) The trends of International aeromedical transport analyzed during 4-year-period from 2009-2012 show the proportion of women increased year by year, from origin 18.3% (11/60) to 34.1%(30/88). Patients age 65 years and above increase from 28.3% (17/60) to 38.63% (34/88). By forwarding mode, air ambulance increase from 5.0% (3/60) to 25.0% (22/88). Moreover, the use of respiratory ventilation in air-ambulance is significant increased from 15.4% (2/13) in 2009 to 55% (11/20) in 2012. Mainland China is still the geographic area that Taiwanese requests for the need of international aeromedical transport. Events of transferred cases happened at locations in Chinese geographic region indicate a demand of the international aeromedical transport shifted from the southeast coastal cities to the inland cities in recent years. The average days from falling ill to activation of transfer is 17.02 days in 2009 and significantly reduces to 9.30 days in 2012. (3) Multiple variables of international medical transport, as mode of transportaion, patient’s age, disease classification, motivation of going abroad, transfer reasons, days of getting sick, transfer staff, medical environment, and the units of expense cost are analyzed. Chi-sqare test is used to note significant correlation. Conclusion：The executing of the international aeromedical transport by the international aeromedical transport team based and supported under hospital is completely successful in this study. It is important that the capacity and ability of medical care system of the hospital should be reaching international level, and the ability and practice of flight nurse and flight physician could be enforceable and constant. The results also show that successful international aeromedical transfer rate of 100% by our team.In Taiwan, the aeromedical transportation is well developed and can be promoted in domestic and international. The high quality of medical care can provide not only to compatriot who is travelling abroad but also foreigner who is requested for emergent medical care. The flight nurse specialist is the core member of the transport team playing an important role of mission operation. Finally, the flight nurse theory of international aeromedical transport is thererfore formed, which can be used as a blueprint of cultivating international aeromedical transfport flight nurses in the future. Key words：international aeromedical transport, mode of transportation, flight nurse, international aeromedical transport team