Background:
Christchurch Hospital is a major trauma centre in the South Island of New Zealand that has played a key role in treating casualties in two recent Mass-Casualty Incidents (MCIs) – the March 2019 Christchurch Mosque Shootings and the December 2019 Whakaari (White Island) Volcano Eruption. The aim of this study was to analyse hospital resource utilisation at Christchurch Hospital (e.g. monetary costs, non-measured and opportunity costs, and human resources) during these two recent MCIs.
Methods:
Cross-sectional data from pre-existing local hospital datasets was analysed to assess hospital resource utilisation (e.g. monetary costs, non-measured and opportunity costs, and human resources) during two MCIs at Christchurch Hospital.
Results:
In total, there were 45 and 8 patients that presented to Christchurch Hospital in relation to the Mosque and Whakaari MCI cohorts. The total length of stay was 15054 hours (average of 335 hours per patient) and 1841 hours (average of 230 hours per patient) in the Mosque and Whakaari cohorts respectively. Mean surgeon time (operative length multiplied by number of surgical staff present) was 293 and 717 minutes in the Mosque and Whakaari cohorts. Burns patients represented a significantly increased surgical workload per operative event than other injuries. There were significant differences in the pattern of staffing; utilisation of blood products and other consumables; utilisation of radiological, pathological, and other services; theatre utilisation; and number of operative events between the two MCI cohorts.
Discussion:
As expected, MCIs with significant burn trauma are more resource intensive than non-burn trauma despite the fact the majority of patients were repatriated within days. A specific clause for additional national funding in event of burn-MCIs exists and has been enacted; to our knowledge no such clause exists for non-burn MCIs.
Conclusion:
This analysis has shown burn-MCIs to place relatively greater demands on acute surgical services than non-burn MCIs.