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Meeting the needs of the accidental medical traveler Stefan Esser

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Agenda

International SOS and Medical Assistance

Medical Travel Risks of Business Travellers

The Challenge of Local Treatment

Reasons for Evacuation or Repatriation

Methods of Evacuations or Repatriations

Summary

Questions

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Travel Security ServicesMedical ServicesAssistance Medicine

26 Assistance Centres Regional Security CentresConsulting

Training

Staffing

Equipment

Ca. 900 remote site clinics world-wide

58 Intl SOS Clinic

Ca. 280 doctors Ca. 900 doctors

10 Air Ambulances

Travel Agencies

4 Regional Flight Desks

International SOS

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Global Infrastructure

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Medical Assistance825,000 medical cases / year

• Managing Health Risks of Travellers

• Case Management

• Medical Advise

Referrals

• Out-Patinets

• In-Patinets

• Evacuations

Repatriations

• Movement of Mortal Remains

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Medical Tourists vs. Accidential Patients825,000 medical cases / year

Medical Tourists / Travel for Treatment

( < 5 %)

• Planned their trip

• Have checked financial issues

• Appreciate the foreign health system

and trust it

• Often come from less developped countries

• Treatment not available in home country

• (Treatment too expensive in home country)

Accidential patients

• Came for work (or holiday)

• Are not prepared for treatment

• Have not checked financial coverage

• Might be reluctant towards a foreign health

system

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The Challenge of Local Treatment(quality)

Mbandaka

Kisangani

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The Challenge of Local Treatment(cultural barriers)

Wuhai

Mengxi

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Reasons for Evacuation

Business Travelers

# Cause% of serious

cases

1 Accident & Injury 21%

2 Cardiovascular & CirculatorySystem Diseases 15%

3 Gastrointestinal Disorders 15%

4 Ill Defined Symptoms - Minor 9%

5 Infectious Diseases - Major 8%

6 Musculoskeletal Disorders 7%

7 Urinary System Disorders 4%

8Gastrointestinal InfectiousDiseases 4%

9 Nervous System Disorders 3%

10 Referrals, Tests & Checkups 3%

Expatriates

# Cause

% of seriouscases

1 Pregnancy 13%

2 Gastrointestinal Disorders 12%

3 Ill Defined Symptoms - Minor 12%

4 Accident & Injury 12%

5 Infectious Diseases - Major 8%

6 Cardiovascular & CirculatorySystem Diseases 8%

7 Musculoskeletal Disorders 7%

8 Gynaecological & ReproductiveSystem Disorders 4%

9 Referrals, Tests & Checkups 4%

10 Urinary System Disorders 4%

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Risk of Evacuation related to medical risk of the country

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Reasons for Evacuation or Repatriationof Accidental Medical Tourists

• Local treatment not possible

• Local treatment not on international standard

• Cultural barriers

• Language barriers

• Social reasons

• Financial reasons

• Mutal decision of – Patient– Employer– Insurance – Medical provider

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Methods of Evacuations or Repatriations

Ground Transport?Air Ambulance ?

Commercial Airline ?

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Lear A 35

Speed :ca. 850 km/h

Starting length: min.1.400 m

Methods of Evacuations or Repatriations

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Methods of Evacuations or Repatriations

King Air Beech 200

Starting length 780 m

Speed 450 km / h

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Methods of Evacuations or Repatriations16,500 / Year

Ground Transport?Air Ambulance ?

Commercial Airline ?

92 %

8 %

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Methods of Evacuations or Repatriations (stretcher)

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Methods of Evacuations or Repatriations (PTC Lufthansa)

Patient Transport Compartment

A330 / A340 / A380 /

B 747-8 / B 747-400

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Methods of Evacuations or Repatriations (military)

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Medical Assistance and Local Care of Accidental Medical Tourists

Local Standard

“Patient Service”

Cultural Understanding

Cost Coverage

Language

Technical Equipment

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Summary

• Injuries and cardiovascular incidents are the main reasons for local care of

accidential medical tourists followed by infectious diseases

• Quality of emergency services count

• The challenge and chance of local treatment needs mutual acceptance

• Social and financial reasons

• Ground transport

• Commercial airlines or air ambulances

• Medical Case Management and Communication

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