Economic impact of patients with medical evacuation in remote islands: a case study in Matsu Islands

ObjectiveAir medical evacuation for residents of remote islands is expensive yet essential for addressing urgent and critical health conditions. This study aims to identify common referral reasons and quantify the economic impact of such services, with a focus on the potential benefits of implementi...

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Main Authors: Ping-Hsuan Hsieh, Bo-Xiang Shi, Chung-Yu Lai, Yin-Chung Chen, Chin Lin, Olivia Wu, Sy-Jou Chen, Shih-Hung Tsai
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1542172/full
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author Ping-Hsuan Hsieh
Bo-Xiang Shi
Chung-Yu Lai
Chung-Yu Lai
Yin-Chung Chen
Chin Lin
Olivia Wu
Sy-Jou Chen
Shih-Hung Tsai
Shih-Hung Tsai
Shih-Hung Tsai
Shih-Hung Tsai
author_facet Ping-Hsuan Hsieh
Bo-Xiang Shi
Chung-Yu Lai
Chung-Yu Lai
Yin-Chung Chen
Chin Lin
Olivia Wu
Sy-Jou Chen
Shih-Hung Tsai
Shih-Hung Tsai
Shih-Hung Tsai
Shih-Hung Tsai
author_sort Ping-Hsuan Hsieh
collection DOAJ
description ObjectiveAir medical evacuation for residents of remote islands is expensive yet essential for addressing urgent and critical health conditions. This study aims to identify common referral reasons and quantify the economic impact of such services, with a focus on the potential benefits of implementing preventive medicine and telemedicine to improve medical care accessibility and coverage in these regions.MethodsWe conducted a retrospective analysis of adult patients who traveled from the Matsu Islands to the Taiwan mainland between January 2016 and June 2022 and divided them into two groups: Emergency Air Medical Transport (EAMT) and non-EAMT. We included both direct medical and non-medical costs, and indirect costs measured by productivity loss due to health conditions. A generalized linear model adjusted for age and gender was employed to estimate average costs per patient.ResultsData were available for 423 participants, with 136 in the EAMT group and 287 in the non-medical evacuation group. The average direct costs were significantly higher in the EAMT group ($12,067, 95% confidence interval [CI] 9,592–15,181) compared to the non-EAMT group ($5,540, 95% CI 4,645–6,608). Transportation costs made up the largest portion of these direct costs, particularly for those requiring EAMT services. The most common referral reasons for EAMT were cardiovascular diseases (27.2%), followed by injuries (21.3%) and general conditions (15.4%). Across all referral reasons, the EAMT group consistently incurred higher average costs compared to the non-EAMT group, with fractures resulting in the highest costs ($21,342, 95% CI 13,794–33,019).ConclusionThe findings highlight the significant financial burden of medical evacuation services in remote islands, particularly for cardiovascular conditions, injuries, and fractures. These results emphasize the need for targeted preventive measures and improved healthcare access to reduce both economic impact and health risks, providing a basis for further cost-effectiveness analysis of future interventions.
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spelling doaj-art-9ef5a65133f749f3b44c09829cfd78892025-08-20T03:05:46ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-05-011310.3389/fpubh.2025.15421721542172Economic impact of patients with medical evacuation in remote islands: a case study in Matsu IslandsPing-Hsuan Hsieh0Bo-Xiang Shi1Chung-Yu Lai2Chung-Yu Lai3Yin-Chung Chen4Chin Lin5Olivia Wu6Sy-Jou Chen7Shih-Hung Tsai8Shih-Hung Tsai9Shih-Hung Tsai10Shih-Hung Tsai11School of Pharmacy, National Defense Medical Center, Taipei, TaiwanSchool of Pharmacy, National Defense Medical Center, Taipei, TaiwanGraduate Institute of Aerospace and Undersea Medicine, National Defense Medical Center, Taipei, TaiwanCombat and Disaster Casualty Care Training Center, National Defense Medical Center, Taipei, TaiwanDepartment of Emergency Medicine, Tri-Service General, Hospital National Defense Medical Center, Taipei, TaiwanSchool of Medicine, National Defense Medical Center, Taipei, TaiwanHealth Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, United KingdomDepartment of Emergency Medicine, Tri-Service General, Hospital National Defense Medical Center, Taipei, TaiwanDepartment of Emergency Medicine, Tri-Service General, Hospital National Defense Medical Center, Taipei, TaiwanSchool of Medicine, National Defense Medical Center, Taipei, TaiwanDepartment of Physiology and Biophysics, Graduate Institute of Physiology, National Defense Medical Center, Taipei, TaiwanTaichung Armed Forces General Hospital, Taichung, TaiwanObjectiveAir medical evacuation for residents of remote islands is expensive yet essential for addressing urgent and critical health conditions. This study aims to identify common referral reasons and quantify the economic impact of such services, with a focus on the potential benefits of implementing preventive medicine and telemedicine to improve medical care accessibility and coverage in these regions.MethodsWe conducted a retrospective analysis of adult patients who traveled from the Matsu Islands to the Taiwan mainland between January 2016 and June 2022 and divided them into two groups: Emergency Air Medical Transport (EAMT) and non-EAMT. We included both direct medical and non-medical costs, and indirect costs measured by productivity loss due to health conditions. A generalized linear model adjusted for age and gender was employed to estimate average costs per patient.ResultsData were available for 423 participants, with 136 in the EAMT group and 287 in the non-medical evacuation group. The average direct costs were significantly higher in the EAMT group ($12,067, 95% confidence interval [CI] 9,592–15,181) compared to the non-EAMT group ($5,540, 95% CI 4,645–6,608). Transportation costs made up the largest portion of these direct costs, particularly for those requiring EAMT services. The most common referral reasons for EAMT were cardiovascular diseases (27.2%), followed by injuries (21.3%) and general conditions (15.4%). Across all referral reasons, the EAMT group consistently incurred higher average costs compared to the non-EAMT group, with fractures resulting in the highest costs ($21,342, 95% CI 13,794–33,019).ConclusionThe findings highlight the significant financial burden of medical evacuation services in remote islands, particularly for cardiovascular conditions, injuries, and fractures. These results emphasize the need for targeted preventive measures and improved healthcare access to reduce both economic impact and health risks, providing a basis for further cost-effectiveness analysis of future interventions.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1542172/fulleconomic burdenair medical evacuationremote islandcost analysismedical evacuation
spellingShingle Ping-Hsuan Hsieh
Bo-Xiang Shi
Chung-Yu Lai
Chung-Yu Lai
Yin-Chung Chen
Chin Lin
Olivia Wu
Sy-Jou Chen
Shih-Hung Tsai
Shih-Hung Tsai
Shih-Hung Tsai
Shih-Hung Tsai
Economic impact of patients with medical evacuation in remote islands: a case study in Matsu Islands
Frontiers in Public Health
economic burden
air medical evacuation
remote island
cost analysis
medical evacuation
title Economic impact of patients with medical evacuation in remote islands: a case study in Matsu Islands
title_full Economic impact of patients with medical evacuation in remote islands: a case study in Matsu Islands
title_fullStr Economic impact of patients with medical evacuation in remote islands: a case study in Matsu Islands
title_full_unstemmed Economic impact of patients with medical evacuation in remote islands: a case study in Matsu Islands
title_short Economic impact of patients with medical evacuation in remote islands: a case study in Matsu Islands
title_sort economic impact of patients with medical evacuation in remote islands a case study in matsu islands
topic economic burden
air medical evacuation
remote island
cost analysis
medical evacuation
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1542172/full
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