1、AN OVERVIEW OF AIR MEDICAL SERVICES航空医疗服务概览（上）DENISE UHLINDENISE UHLIN CUSTOMER SOLUTIONS MANAGER BELL 客户方案经理客户方案经理-贝尔贝尔 2018 Bell Helicopter Textron Inc.2EMERGENCY MEDICAL SERVICES/AVIATION急救医疗服务急救医疗服务/航空航空40+Years Experience 40多年经验PRE-HOSPITAL/HOSPITAL EMERGENCY MEDICAL SERVICES院前急救院前急救/医院急救医疗服务医院
2、急救医疗服务Nationally Registered Paramedic/Ground&Air Medical Services 国家注册护理人员/地面及航空医疗服务Program Director/Chief Flight Nurse(UNC HOSPITALS,CHAPEL HILL)项目总监/首席飞行护士（北卡罗来纳大学医院，教堂山）Regional Safety Director(AIR METHODS CORP）区域安全总监（Air Methods公司）AVIATION 航空航空Director Air Medical Services (PHI AEROMEDICL SERVIC
3、ES)航空医疗服务总监（PHI AEROMEDICL SERVICES 公司）Western Hemisphere Director Quality&Safety(BRISTOW GROUP)西半球质量兼安全总监（Bristow集团）BELL Customer Solutions Manager/EMS 贝尔-客户方案经理/医疗应急救援Hired to support China in developing world class air medical services for its citizens 协助支持中国开展先进的航空医疗服务，造福人民INDUSTRY TERMINOLOGY行业
4、术语行业术语Common:HEMS(Helicopter Emergency Medical Service)HEMS（直升机医疗急救服务）HAA(Helicopter Air Ambulance)HAA(直升机空中救护车)General:AMS(Air Medical Services)AMS(航空医疗服务)System designed to meet Chinas unique needs 研究符合中国特色的体系Reflects expanded service models 反映可延伸的服务模式Bell Confidential and Non Proprietary3PRESENTA
5、TION OBJECTIVES演讲目的演讲目的WHY providing air medical services is important航空医疗服务为何为何如此重要？Decreased mortality 降低死亡率 Increased clinical outcomes 增加临床成果HOW to provide air medical services如何如何提供航空医疗服务 Funding models 资金模式 Operating structures 营运架构Bell Confidential and Non Proprietary4AIR MEDICAL SOLUTIONS FO
6、R CHINA中国的航空医疗解决方案中国的航空医疗解决方案Bell will support China in developing Air Medical Services that are safe,efficient&economically sustainable,while providing a high level of care to the greatest number of citizens贝尔将协助中国开展安全、有效、经济的可持续发展航空医疗服务，贝尔将协助中国开展安全、有效、经济的可持续发展航空医疗服务，并为最大数量的公民提供高水平关怀服务并为最大数量的公民提供高水平
7、关怀服务 Options are ENDLESS commercial 135 operations funded by insurance-one of many options 数不清的可选方案 由保险基金支持的135家商业运营商 多选一 Develop unique,air medical service by leveraging best practices,&expanding or redefining traditional systems 利用借鉴最佳实践方案发展独特的航空医疗服务，扩展并再定义传统方案。The system should allow for a mixtur
8、e of operations&equipment which provide the most coverage&care 该体系应允许混合经营及设备，以达到最大的覆盖面及服务Bell Confidential and Non Proprietary5Greater Access=Improved Patient Survival and Functionality更好的渠道更好的渠道=更多的病患被救助更多的病患被救助+更完善的功能更完善的功能 IMPROVING ACCESS TO HEALTHCARE改善医疗服务的渠道改善医疗服务的渠道Improving the peoples well
9、being and access to healthcare is critical to becoming a modern,developed society.President Xi emphasized this as a continued area of focus for China during the 19th CPC National Congress.要成为一个现代化的发达社会载体，改善人民的幸福指数和享受医疗服务的渠道是非常关键的。习主席在中共19届全国代表大会上也强调对此需要持续关注。Building an effective Helicopter Emergency
10、 Medical Service(HEMS)system across China is necessary to preserve life and improve wellbeing for the greater good of all people.在全中国建立有效的直升机医疗急救服务（HEMS）体系，对于挽救生命，改善全民健康是非常有必要的。Bell Confidential and Non Proprietary62016 260,000 traffic deaths in China-Many could be prevented with AMS Network2016年，在中
11、国，超过年，在中国，超过26万人死于交通事故；如有万人死于交通事故；如有航空医疗服务（航空医疗服务（AMS）网络，）网络，很多死亡可以避免。很多死亡可以避免。BRIEF HISTORY历史回顾Bell Confidential and Non Proprietary7THE US EXPERIENCE美国经验美国经验 Helicopters first used for medical evac by military in the 1950s 1970s 在20世纪50年到20世纪70年代，直升机开始被军方用于医疗 Government programs led to dual-purpos
12、e use of military&public safety helicopters(Maryland State Police,MAST)政府项目引导直升机同时为军方及公共安全事业服务(马里兰州警察局，MAST）Mid 1980s expansion to commercial ops with growth explosion thru 1990s to present day 20世纪80年代中期，延伸至商业运营行业；并从20世纪90年代至今呈现爆发式增长态势 Organized,coordinated efforts in the US date back nearly 50 yea
13、rs 在美国，这样有序和谐的发展可追溯到近50年前Bell Confidential and Non Proprietary80200400600800100012001970197519801985199019952000200520102015US HEMS FleetSource:ASCENDTHE US EXPERIENCE美国经验美国经验 Over last 50 years,every imaginable model&structure used for Air Medical Services in the US 在美国，过去的50多年里，每一个可想象的模式和架构都被用于航空医
14、疗服务。What proves successful for one region,state,or even country,may not work for another 具体问题具体分析，因地制宜。2018 Bell Helicopter Textron Inc.9CURRENT STATUS目前状况目前状况US 1200 civil&government helicopters serving 320 million 美国超过1200架民用及政府直升机服务3亿2千万人口 1 helicopter/267,000 people 平均一架直升机服务26万7千人China 100 AMS
15、helicopters to serve 1.4 billion people中国 不到100架 AMS直升机服务14亿人口With US ratio-5,243 helicopters to cover population 如果按照美国现状比例，应该有5243架直升机AMS in China should involve a combination of:中国的AMS应该涵盖：Government operations 政府运营 Part 91 Operations 91部运营 Part 135 Operations 135部运营 2018 Bell Helicopter Textron
16、Inc.10CHINA US COMPARISON 中美情况对比中美情况对比Geographic sq.km.footprint of China vs US.地理分析 中美“足迹”对比Variations comparing additional demographics:人口统计方面不同的对比Physician density 医生密度Hospital bed density医院床位密度Bell Confidential and Non Proprietary11Tremendous Air Medical Services Growth potential for ChinaCHINA
17、US COMPARISON 中美情况对比中美情况对比 2018 Bell Helicopter Textron Inc.12Physicians density医生密度医生密度1.49 physicians医生/1,000 population人(2011)2.55 physicians医生/1,000 population人(2013)Hospital bed density医院床位密度医院床位密度3.8 beds 张床/1,000 population 人(2011)2.9 beds张床/1,000 population 人(2011)China 中国中国United States 美国美
18、国Population 人口人口1,373,541,278(2016)323,995,528(2016)Area 国土面积国土面积9,596,960 sq.km平方千米9,833,517 sq.km平方千米Consider a model that gets patient to the doctor/higher level of care思考一种可以让病患有医生资源或更高水平的医疗服务的模式思考一种可以让病患有医生资源或更高水平的医疗服务的模式FLEXIBILITY IN AIR MEDICAL SERVICES OPTIONS更灵活的航空医疗服务模式更灵活的航空医疗服务模式More th
19、an one way to operate SAFELY under US regulations:在美国法规下，安全运营可遵循不止一种法规Part 91 91部Part 135 135部Focus on Capability&Availability容量及实用性Maximize use of single engine,single pilot operations to provide greatest coverage economically 最大化使用单发单驾驶操作，来更经济地实现最大的覆盖量91%Bell AMS sales to North America are single
20、engine 贝尔AMS销售到北美的91%都是单发直升机Bell Confidential and Non Proprietary13Bell committed to helping China develop their air medical and emergency service solutions贝尔承诺将帮助中国发展其航空医疗急救服务行业贝尔承诺将帮助中国发展其航空医疗急救服务行业Bell Confidential and Non Proprietary14航空医疗服务航空医疗服务有什么益处？有什么益处？为什么重要？为什么重要？WE ALL REALIZE.我们认识到我们认识到
21、Air Medical Services SAVE LIVES!空中救援服务可以拯救生命！空中救援服务可以拯救生命！Benefits extend beyond the trauma scene flight 空中救援服务带来的优势远远不止灾难现场的救援 Any condition to benefit from advanced care&/or rapid transport 满足包括高级医疗救护以及快速转运之内的所有情况需求Benefits accomplished thru 3 inter-related functions:这些优势得益于以下的三个核心功能rapid expert c
22、are to victim,which in turn.专业人员快速抵达现场decreases mortality,and.有效降低死亡率improves outcomes.更好的救援结果Bell Confidential and Non Proprietary15Improved outcomes are a major factor in effectiveness of medical care更好的救援结果是高效医疗救援最主要的因素更好的救援结果是高效医疗救援最主要的因素PATIENT OUTCOMES 病患的结果病患的结果Primary Outcome Variables病患主要的可
23、变因素病患主要的可变因素Survival 存活率Functional 功能性Both equally important,for example:Undesirable for patient to survive but to remain in vegetative state生存和保持机体的功能两者同样重要，因为病患活下来，但是却进入植物人状态并不是一个理想的结果Bell Confidential and Non Proprietary16Secondary Outcome Variables病患的次要可变因素病患的次要可变因素Physiologicdecrease morbidity&
24、mortality(manage breathing,stop bleeding)物理因素-减轻症状并减小死亡率（控制呼吸，有效止血）Logistic-decrease time parameters(time to surgery,procedures)逻辑因素-较少时间影响（送医时间以及程序）Decreased ICU&hospital stays减少重症监护室以及住院的时间 orAMS addresses by:1)Getting to patient quickly 2)Providing advanced level of careRESEARCH SUPPORTING AMS EF
25、FECTIVENESS研究数据支持了航空医疗服务的有效性研究数据支持了航空医疗服务的有效性 2018 Bell Helicopter Textron Inc.17Samplais-Transport to a Level 1 facility decreases the odds of death by 38%Samplais-运输至1级医疗设施使病患死亡的概率减小了38%UK Study Increased survival in patients with low probability of survival due to combination of HAA&care at the h
26、ospitalUK Study 生存几率很低的重症病人的存活率因为医疗救护直升机（HAA）和医院的紧急救护得到了提高Nardi-HAA crew stabilization&advanced care at the scene&enroute is associated with a threefold decrease in mortality compared to ground transportNardi-相比地面救护，医疗救护直升机（HAA）机组的稳定化和专业化配合先进的灾难现场以及航程中的救护使病人的死亡率降低了三倍Baxt&Moody-300 patient outcomes e
27、xamined using injury severity scores to predict mortality,only difference ground vs air HAA had 52%decrease in predicted mortalityBaxt&Moody-通过对300例病伤情严重程度以及患治疗结果的分析，预测接受医疗救护直升机（HAA）服务的病人死亡率将比地面救护的病人低52%Air Medical Services decrease mortality and improve clinical outcomes空中医疗服务降低死亡率并提升临床医疗效果空中医疗服务降低死亡率并提升临床医疗效果
