Affiliations: [a] Institute of Pathology, Charité – University Medicine Berlin, Campus Mitte, Schumannstrasse 20/21, 10117 Berlin, Germany | [b] Department of Health Care Management, Faculty of Economics and Management, Berlin University of Technology, Institute for Technology and Management, Secr. EB2, Strasse des 17 Juni 145, 10623 Berlin, Germany
Correspondence:
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Corresponding author: Dr. rer. oec. Jonas Schreyögg, E-mail: [email protected].
Abstract: Objectives:The purpose of this study is to assess the cost-effectiveness (net costs per life year gained) of telemedical devices for pre-clinical traffic accident emergency rescue in Germany. Methods:Two equipment versions of a telemedical device are compared from a societal perspective with the baseline in Germany, i.e. the non-application of telemedicine in emergency rescues. The analysis is based on retrospective statistical data covering a period of 10 years with discounted costs not adjusted for inflation. Due to the uncertainty of data, certain assumptions and estimates were necessary. The outcome is measured in terms of “life years gained” by reducing therapy-free intervals and improvements in first-aid provided by laypersons. Results:The introduction of the basic equipment version, “Automatic Accident Alert”, is associated with net costs per life year gained of €247,977 (at baseline assumptions). The full equipment version of the telemedical device would lead to estimated net costs of €239,524 per life year gained. Multi-way sensitivity-analysis with best and worst case scenarios suggests that decreasing system costs would disproportionately reduce total costs, and that rapid market penetration would largely increase the system’s benefit, while simultaneously reducing costs. Conclusion:The net costs per life year gained in the application of the two versions of the telemedical device for pre-clinical emergency rescue of traffic accidents are estimated as quite high. However, the implementation of the device as part of a larger European co-ordinated initiative is more realistic.
Keywords: Cost-benefit analysis, telemedicine, emergency medical services, ambulances, traffic accidents
