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Factors impacting on the activation and approach times of helicopter emergency medical services in four Alpine countries
Iztok Tomazin, Miljana Vegnuti, John Ellerton, Oliver Reisten, Guenther Sumann, Janko Kersnik, 2012, original scientific article

Abstract: Background: The outcome of severely injured or ill patients can be time dependent. Short activation and approach times for emergency medical service (EMS) units are widely recognized to be important quality indicators. The use of a helicopter emergency medical service (HEMS) can significantly shorten rescue missions especially in mountainous areas. We aimed to analyze the HEMS characteristics that influence the activation and approach times. Methods: In a multi-centre retrospective study, we analyzed 6121 rescue missions from nineHEMS bases situated in mountainous regions of four European countries. Results: We found large differences in mean activation and approach times among HEMS bases. The shortest mean activation time was 2.9 minutes; the longest 17.0 minutes. The shortest mean approach time was 10.4 minutes; the longest 45.0 minutes. Short times are linked (p < 0.001) to the following conditions: helicopter operator is not state owned; HEMS is integrated in EMS; all crew members are at the same location; doctors come from state or private health institutions; organization performing HEMS is privately owned; helicopters are only for HEMS; operation area is around 10.000 km2; HEMS activation is by a dispatching centre of regional government who is in charge of making decisions; there is only one intermediator in the emergency call; helicopter is equipped with hoist or fixed line; HEMS has more than one base with helicopters, and one team per base; closest neighboring base is 90 km away; HEMS is about 20 years old and has more than 650 missions per year; and modern helicopters are used. Conclusions: An improvement in HEMS activation and approach times is possible. We found 17 factors associated with shorter times.
Keywords: emergency medical services, air ambulances, emergency helicopters, quality of health care, activation and approach time
Published: 29.06.2017; Views: 568; Downloads: 170
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Health services utilization in older Europeans
Andrej Srakar, Rok Hren, Valentina Prevolnik Rupel, 2016, original scientific article

Abstract: Background and Purpose: Chronic diseases and associated co-morbidities are highly prevalent among elderly and are associated with an increase in health services utilization which in turn raises health care expenditures throughout industrialized societies. However, health care utilization in elderly is still inadequately understood, particularly regarding the differences among European jurisdictions. In our article, we use dataset of Wave 5 of SHARE survey to study the utilization of health care in older Europeans in 15 European countries. Design/Methodology/Approach: We investigate relationships between factors such as age, gender, income, education and health variables and the utilization of various types of health services. We apply regression modeling to study the determinants of health utilization (different socioeconomic and health variables) of older people. Results: We show some significant differences between determinants of health utilization in terms of probability and frequency of usage. We also explore patterns between welfare regimes, taking Eastern European jurisdictions as a reference category. Finally, we show that in a simple causal model the provision of formal and/or informal homecare serves as a complement to utilization of health care services. Conclusion: Results of our article are important for the management of health care facilities in terms of health care usage by older people, and can be of value to health care providers and policy makers in the field.
Keywords: health services, health care, services, utilization, users, elderly people, analysis, Europe
Published: 30.11.2017; Views: 279; Downloads: 64
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