title: Cost-effectiveness analysis of telemedical devices for pre-clinical traffic accident emergency rescue in Germany.
abstract: OBJECTIVE
  The purpose of this study is to assess the cost-effectiveness (net costs per life year gained) of telemedical devices for pre-clinical traffic accident emergency rescue in Germany.
  
  
  METHODS
  Two equipment versions of a telemedical device are compared from a societal perspective with the baseline in Germany, i.e. the non-application of telemedicine in emergency rescues. The analysis is based on retrospective statistical data covering a period of 10 years with discounted costs not adjusted for inflation. Due to the uncertainty of data, certain assumptions and estimates were necessary. The outcome is measured in terms of "life years gained" by reducing therapy-free intervals and improvements in first-aid provided by laypersons.
  
  
  RESULTS
  The introduction of the basic equipment version, "Automatic Accident Alert", is associated with net costs per life year gained of euro 247,977 (at baseline assumptions). The full equipment version of the telemedical device would lead to estimated net costs of euro 239,524 per life year gained. Multi-way sensitivity-analysis with best and worst case scenarios suggests that decreasing system costs would disproportionately reduce total costs, and that rapid market penetration would largely increase the system's benefit, while simultaneously reducing costs.
  
  
  CONCLUSIONS
  The net costs per life year gained in the application of the two versions of the telemedical device for pre-clinical emergency rescue of traffic accidents are estimated as quite high. However, the implementation of the device as part of a larger European co-ordinated initiative is more realistic.
authors.affiliation: Institute of Pathology, Charité - University Medicine Berlin, Campus Mitte, Schumannstrasse 20/21, 10117 Berlin, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Auerbach
authors.forename: J
authors.initials: J
authors.lastname: Schreyögg
authors.forename: R
authors.initials: R
authors.lastname: Busse
mesh_terms: D000063:Accidents, Traffic; D003362:Cost-Benefit Analysis; D004631:Emergency Medical Service Communication Systems / Q000191:economics*; D005858:Germany; D017048:Health Care Costs; D006801:Humans; D016015:Logistic Models; D019057:Quality-Adjusted Life Years; D018635:Rescue Work / Q000191:economics; D017216:Telemedicine / Q000191:economics* / Q000295:instrumentation*; D026712:Value of Life / Q000191:economics