Increasing numbers of foreign tourists, expatriates, and patients seeking medical care in Thailand have resulted in a significant increase in aeromedical transport activity, both evacuation and repatriation over the past decade. However, there is little epidemiological data currently available on the diagnoses, costs and transport characteristics in Thailand and Southeast Asia. We therefore performed a descriptive analysis of evacuation and repatriation cases in order to compare helicopter and fixed-wing transport in various ways such as flight time, distance and economic aspects.
A retrospective review of medical records of patients in 2011 evacuated or repatriated by the Aviation Medicine Department, Bangkok Hospital. Demographic information, diagnoses, modes of transport, type of aircraft, flight time and financial detail were analyzed.
Three hundred and two patients were included in the study, 201 male (66.5%) and 101 female (33.5%). Patients’ ages ranged from 1 day to 105 years, the average age was 50.2 years. (Median 54 years). The top three nationalities of patients were Thai (n = 93, 30.8%), Myanmar (n = 29, 9.6%) and British (n = 19, 6.3%). The top four diagnoses were Stroke (n = 51, 16.6%), Multiple trauma (n = 41, 13.40%), Acute myocardial infraction (AMI) (n = 30, 9.8%), Cancer (n = 27, 8.9%). Transports were carried out by air ambulance (n = 104, 34%, $202.5/min), helicopter (n = 84, 28%, $87.55/min), scheduled aircraft with regular seating (n = 60, 20%, $9.37/min) and a stretcher in a scheduled aircraft (n = 54, 18% $40.1/min).
By comparing the costs per flight time, we showed that a stretcher in a scheduled aircraft is significantly cheaper than an air ambulance. Ideally the most appropriate medical response would be the main criteria when choosing a form of air transportation; however cost-effectiveness is also of considerable importance when selecting from the alternatives available. It is the main role of the physician who is in charge of transport planning to communicate the evaluation of mode of air medical transport.
aeromedical transport, epidemiology, evacuation, repatriation, air medical transport, aviation medicine, air ambulance, helicopter