Evaluation of hospital-based aeromedical transport programs using therapeutic intervention scoring.
The number of patients transported by hospital-based aeromedical transport programs is increasing rapidly across the country. How many of these patients really need this kind of transport and how to compare the performance of different services in this regard remain controversial issues. We examined these questions in a prospective analysis of 1,081 flights in 5 aeromedical transport programs using the Therapeutic Intervention Scoring System (TISS) as the basis for an index of appropriateness. An average of 41.5% of flights in all programs were clearly appropriate according to the index, i.e., had scores associated with a 99% probability of validation by direct review. Another 34.9% of flights had a greater than 50% probability of being appropriate. From 18 to 28% of flights had scores associated with only a 20% probability of justification. Although TISS scoring, which is carried out after transfer, cannot provide a means of selecting individual patients for aeromedical transfer, a TISS-based index appears to be a simple and useful method for examining overall appropriateness of program activity, and could be used to set objective standards of appropriateness for evaluation and comparison of aeromedical programs.
Burney
R E
RE
Department of Surgery, University of Michigan, Ann Arbor.
Rhee
K J
KJ
Cornell
R G
RG
Bowman
M
M
Storer
D
D
Moylan
J
J
D000401:Aircraft; D004636:Emergency Service, Hospital; D005069:Evaluation Studies as Topic; D011446:Prospective Studies; D012189:Retrospective Studies; D014187:Transportation of Patients