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Tue May 1 02:22:13 BST 2007

In a message dated 4/30/2007 6:06:48 P.M. US Mountain Standard Time,  
KMATTOX at aol.com writes:

I have  been watching this discussion point.    I have not  comment on  
purpose 
as I wanted to see just how this would unfold.    Air  Ambulance use for off 
shore, high rise, and wilderness RESCUE is   essential.   Air ambulance for 
most 
urban and suburban areas of  the  WORLD are overused, over expensed, and 
complications, death  rates, and safety  records under reported.     
Thank you Dr. Mattox - patient safety and EBM are sadly not yet  guiding 
out-of-hospital care (air and ground) practice in much of our  country. Adverse 
events, complication rates, and safety issues are GROSSLY  under-reported. 
Secondary OUTCOMES beyond dead or alive at 24 hours are not even  measured by many 
transport programs. Programs that are actively providing care  based on 
evidence and not eminence, sharing data and safety, not fluffing and  buffing 
numbers, or covering up blunders would seem to unfortunately be  the exception. 

>From a strictly scientific standpoint, air ambulance use in urban  and  
suburban areas cannot be supported.   From an economic  standpoint,  
including public 
relations and filling unfilled hospital  beds, air ambulance use  are 
excellent vehicles if the case mix is such  that sufficient number of the  
passengers 
have some form of  payment.    From a cost effective  analysis risk adjusted 
and  
time adjusted standpoint one can never defend air  ambulance use.   

But like CEO salaries, NFL 1s round draft choices, and politics,  our  
discussions have very little chance in changing the   overexpenses.     

k

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