Page 180 - Timeliness of Infectious Disease Notification & Response Systems - Corien Swaan

178 Chapter 8
this epidemic, it is important to discuss whether it is necessary that every am- bulance care service and hospital nationwide ought to be prepared for a threat of this magnitude. Dividing ambulance costs by the number of transportations (12) and hospital costs by the number of admissions (14) would result in about €123,000 per transportation and €599,000 per admission of a suspected or di- agnosed case. Instead, a few selected organisations might fulfil these tasks for the whole country, while the rest could rely on more general preparedness [25]. Major expansion of capacity and resources is thus required only within these select organisations. In the UK, for example, suspected EVD patients could only be admitted for treatment to high-level isolation units at just two hospitals [37, 38]. In Israel, the Ministry of Health designated a single hospital to serve as the national Ebola treatment centre, whereas the other hospital emergency depart- ments were instructed to offer only life-saving interim care for suspected cases while following strict isolation and personal protection practices [39].
In conclusion, the large unforeseen and unbudgeted expenses for EVD preparedness and response posed a substantial financial burden on the Dutch health system, especially ambulance care, peripheral and academic hospitals. The nationwide experience and collaboration of healthcare organisations that managed patients with suspected EVD can serve as a valuable resource for fu- ture outbreaks of other highly infectious diseases [40]. Ongoing updating of guidelines and training will be needed to sustain the preparations for upcom- ing outbreaks. Designating one ambulance service and just a few hospitals for the transportation and admission of patients with suspected viral haemorrhagic fever or other highly infectious disease might improve efficiency and reduce future costs.