Potential reduction of costs and hospital emergency department visits resulting from prehospital transtelephonic triage - the Shahal experience in Israel
A. Roth et al., Potential reduction of costs and hospital emergency department visits resulting from prehospital transtelephonic triage - the Shahal experience in Israel, CLIN CARD, 23(4), 2000, pp. 271-276
Background: The rising cost of services provided by hospital emergency depa
rtments is of major concern. Attempts to reduce the costs of emergency card
iac care have thus far focused primarily on medical and administrative mana
gement in the hospital. The role of the patient in appropriate prehospital
decision-making has been generally ignored.
Hypothesis: Membership in "Shahal" (an integrative telemedicine system) may
have beneficial effects on patient decision-making and national health cos
ts.
Methods: During a 6-month period, a random group of subscribers who had cal
led fur medical assistance during the previous 24 h were asked what action
they would have taken had they not been Shahal subscribers. All study patie
nts were followed for at least 7 days.
Results: In all, 1,608 subscribers (age 71 +/- 13 years) were included. Of
these, 514 replied that they "would have waited," 363 "would have contacted
their physicians," and 731 "would have sought emergency department care."
Of the presenting medical problems, 86% were resolved without utilizing hos
pital facilities. A mobile intensive care unit was dispatched in 412 (26%)
cases, A cost estimate of abuse indicated that the service resulted in a sa
vings to the national economy of approximately $830,000 per 10,000 members
per year.
Conclusions: This study demonstrated that Shahal membership can reduce cost
s of medical care and the number of hospital emergency department visits.