Jack E Kornfeld1, Micah G Katz2, James R Cardinal3, Batsaikhan Bat-Erdene4, Gerelmaa Jargalsaikhan4, Jade Nunez5,6. 1. Dartmouth Medical School, 1 Medical Center Dr, Lebanon, NH, USA. 2. Center for Global Surgery, University of Utah, 30 N 1900 E, RM 3B110 SOM, Salt Lake City, UT, USA. 3. School of Medicine, University of Utah, 30 N 1900 E, Salt Lake City, UT, USA. 4. Department of Surgery, Mongolian National University of Medical Sciences, Zorig Street, Ulaanbaatar, Mongolia. 5. Center for Global Surgery, University of Utah, 30 N 1900 E, RM 3B110 SOM, Salt Lake City, UT, USA. Jade.Nunez@HSC.Utah.edu. 6. University of Utah, 30 N 1900 E, SOM 3B202, Salt Lake City, UT, 84132, USA. Jade.Nunez@HSC.Utah.edu.
Abstract
BACKGROUND: Trauma is the leading cause of death among Mongolians aged 24-44. To improve initial management of injured patients, the Mongolian National University of Medical Sciences (MNUMS) implemented the American College of Surgeons' (ACS) Advanced Trauma Life Support (ATLS) training program in 2015. Cost analysis demonstrates that such programs can have clear pathways to self-sufficiency. METHODS: Costs associated with an ACS Mongolian ATLS program were quantified based on discussions with the Mongolian government, MNUMS, ATLS Australasia headquarters, and existing pricing data. Costs were then classified as either essential or contingencies. These classifications determined budgetary items for each program. Savings projections for contingencies included training Mongolian instructors and educators. Scenarios for funding the budget were then assessed. RESULTS: The minimum annual cost of ATLS in Mongolia, which includes 3 ATLS student courses/1 instructor course, is $10,709. A budget of $19,900 includes additional contingencies. The scenario that involves foreign instructors is the most expensive one. An initial investment of $85,000 to train Mongolian instructors reduces annual costs by $48,305 (71% reduction). An investment of $4050 to train a Mongolian educator will reduce costs by $1750 annually. ATLS can be sustained with 0.04% of Mongolia's current spending on public health and preventative services. CONCLUSIONS: Initial investment to train Mongolian ATLS instructors leads to substantial savings. Training a Mongolian educator lowers long-term costs. When minimum costs for ATLS courses are understood, these can be scaled up and supported with different contingencies and minimal funding by government or third-party stakeholders.
BACKGROUND:Trauma is the leading cause of death among Mongolians aged 24-44. To improve initial management of injured patients, the Mongolian National University of Medical Sciences (MNUMS) implemented the American College of Surgeons' (ACS) Advanced Trauma Life Support (ATLS) training program in 2015. Cost analysis demonstrates that such programs can have clear pathways to self-sufficiency. METHODS: Costs associated with an ACS Mongolian ATLS program were quantified based on discussions with the Mongolian government, MNUMS, ATLS Australasia headquarters, and existing pricing data. Costs were then classified as either essential or contingencies. These classifications determined budgetary items for each program. Savings projections for contingencies included training Mongolian instructors and educators. Scenarios for funding the budget were then assessed. RESULTS: The minimum annual cost of ATLS in Mongolia, which includes 3 ATLS student courses/1 instructor course, is $10,709. A budget of $19,900 includes additional contingencies. The scenario that involves foreign instructors is the most expensive one. An initial investment of $85,000 to train Mongolian instructors reduces annual costs by $48,305 (71% reduction). An investment of $4050 to train a Mongolian educator will reduce costs by $1750 annually. ATLS can be sustained with 0.04% of Mongolia's current spending on public health and preventative services. CONCLUSIONS: Initial investment to train Mongolian ATLS instructors leads to substantial savings. Training a Mongolian educator lowers long-term costs. When minimum costs for ATLS courses are understood, these can be scaled up and supported with different contingencies and minimal funding by government or third-party stakeholders.
Authors: Franck G Billmann; Claude Burnett; Stefanie Welke; Therezia Bokor-Billmann Journal: Wilderness Environ Med Date: 2013-09-25 Impact factor: 1.518