Spatial analysis of non-urgent ambulance transport: a possibility of overnight stay for radiotherapy patients at the Institute of Oncology

Abstract

Introduction: Cancer patients from different regions of Slovenia who come to the Institute of Oncology to attend radiotherapy are not offered the option of paid overnight stay in Ljubljana. The patients' preferences regarding overnight stay were analysed and costs of different transport/overnight stay combinations were calculated. Methods: Data on patient preferences were acquired through questionnaires completed by patients receiving radiotherapy at the Institute of Oncology in Ljubljana at a specified date. The preferences were estimated using CART methods (classification and regression trees). The costs of different combinations of financing overnight stay/transport were estimated using breakeven point analysis based on official documents dealing with payment of non-urgent ambulance transport. Results: Data analysis showed that overnight stays are cost effective for transports of patients who live more than 38 km away from the Institute, assuming that the cost of overnight stay is 40 EUR. Transport was preferred by 55% of the patients, and overnight stay in Ljubljana by 20%. The rest of them could not decide because of the lack of information. CART analysis showed that among the nonusers of ambulance transport overnight stays were preferred by patients younger than 37 years, living at a distance of more than 24 km from Ljubljana. Total annual costs of non-urgent transports were found to amount to 3.31 million EUR. Conclusions: The best solution would be to change the policy of financing non-urgent transports, and at the same time, to give patients from distant locations the right to stay in Ljubljana overnight; as estimated, the costs would thereby be reduced by 57%. If this change in financing transports is not possible, the best solution would be to enable patients from distant locations to stay in Ljubljana overnight, a measure that would result in 17% savings of current costs.