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Telemedical emergency services: central or decentral coordination?

Steffen Fleßa (), Rebekka Suess, Julia Kuntosch, Markus Krohn, Bibiana Metelmann, Joachim Paul Hasebrook, Peter Brinkrolf, Klaus Hahnenkamp, Dorothea Kohnen and Camilla Metelmann
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Steffen Fleßa: University of Greifswald
Rebekka Suess: University of Greifswald
Julia Kuntosch: University of Greifswald
Markus Krohn: University of Greifswald
Bibiana Metelmann: University of Greifswald
Joachim Paul Hasebrook: University of Greifswald
Peter Brinkrolf: University of Greifswald
Klaus Hahnenkamp: University of Greifswald
Dorothea Kohnen: University of Greifswald
Camilla Metelmann: University of Greifswald

Health Economics Review, 2021, vol. 11, issue 1, 1-12

Abstract: Abstract Background and objective Teleemergency doctors support ambulance cars at the emergency site by means of telemedicine. Currently, each district has its own teleemergency doctor office (decentralized solution). This paper analyses the advantages and disadvantages of a centralized solution where several teleemergency doctors work in parallel in one office to support the ambulances in more districts. Methods The service of incoming calls from ambulances to the teleemergency doctor office can be modelled as a queuing system. Based on the data of the district of Vorpommern-Greifswald in the Northeast of Germany, we assume that arrivals and services are Markov chains. The model has parallel channels proportionate to the number of teleemergency doctors working simultaneously and the number of calls which one doctor can handle in parallel. We develop a cost function with variable, fixed and step-fixed costs. Results For the district of Greifswald, the likelihood that an incoming call has to be put on hold because the teleemergency doctor is already fully occupied is negligible. Centralization of several districts with a higher number of ambulances in one teleemergency doctor office will increase the likelihood of overburdening and require more doctors working simultaneously. The cost of the teleemergency doctor office per ambulance serviced strongly declines with the number of districts cooperating. Discussion The calculations indicate that centralization is feasible and cost-effective. Other advantages (e.g. improved quality, higher flexibility) and disadvantages (lack of knowledge of the location and infrastructure) of centralization are discussed. Conclusions We recommend centralization of telemedical emergency services. However, the number of districts cooperating in one teleemergency doctor office should not be too high and the distance between the ambulance station and the telemedical station should not be too large.

Keywords: Centralisation; Emergency medicine; Queuing model; Teleemergency doctor; Telemedicine (search for similar items in EconPapers)
Date: 2021
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DOI: 10.1186/s13561-021-00303-5

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