During a bike trip in Chile, Paul takes a tumble and injures himself badly. Since the local medical care is insufficient, he has to return to Switzerland for an operation. But how is such return transportation carried out and what can Paul now expect?
During a bike trip in the Chilean Andes, Paul takes a tumble. He breaks his arm and takes a heavy hit to the head causing concussion. In the hospital he calls AXA telling them he needs to return home as soon as possible. Paul is connected with Medicall, the emergency call center abroad, which organizes his immediate transportation back to Switzerland. But how is return transportation, or repatriation, carried out, and what can you expect?
We spoke with Steffen Bohn, Head of Medical Assistance at Medicall:
Regardless of the diagnosis and quality of care in the vacation country, the policyholder should call AXA's international emergency telephone number following an accident or illness. His call lands directly in our emergency call center. So we can immediately take the necessary measures. Whether the policyholder is repatriated and, if so, how, depends on the diagnosis, the vacation country, and the required rescue transportation. If return transportation is necessary, we organize this within 24 to 48 hours.
First of all, we inform Paul's basic health insurance that assumes the hospital costs its customer has reported via the AXA emergency number. Since a repatriation is being discussed in Paul's case, our doctors at AXA become involved. They judge whether the repatriation is "medically necessary" or "medically sensible." "Medically necessary" means that the customer is in a region in which medical services are undersupplied compared with Swiss standards. In Paul's case, this is true: He is transported back to Switzerland for reasons of medical necessity so that he can be treated here. However, immediate return transportation can also be classified as "medically sensible." If Paul were in an accident in France, for example, he would have been well treated locally – as in almost all Central European countries. We would then advise Paul to undergo the operation in the country in which the accident took place. If we propose not to carry out repatriation, then this is always in keeping with the interests and the well-being of the patient. But if someone insists on returning home, return transportation will be organized.
In selecting the means of transportation, the distance to Switzerland is decisive. For distances up to 750 km, Medicall prefers a ground-based return, i.e. an ambulance. For distances greater than 750 km, we bring the patient home by air. There are two options: using a scheduled airline service or by ambulance jet. Our doctors decide what medical assistance the patient needs and whether he is accompanied by a doctor or a rescue worker. In this way, we ensure a medically safe journey home.
No, this depends on the injury. For example, Paul – as long as his health allows – would be repatriated on a scheduled flight, given his injuries.
For scheduled flights, there are large differences depending on the diagnosis, the country and the injury. Intercontinental flights are always in business class, so that the patient has the possibility to lie flat. For European flights, economy seats will be booked, if necessary with additional seats. However, if, for example, a patient has suffered a serious traffic accident and several injuries, one of which is life-threatening, he will be transported by ambulance jet as soon as he is capable of being flown.
Further treatment is the main focus, and the patient is brought to a suitable hospital. We would place Paul in a hospital with a surgical station. Patients brought home by scheduled flight are collected at the airport by ambulance that takes them to the chosen hospital. For patients from the ambulance jet, an ambulance will be waiting for them close to the airport runway. Our medical staff, who accompany every repatriation, then transfer the patient to the attending physician at the hospital. Finally, we report to AXA that the patient has arrived safely at the chosen hospital.