medRxiv : the preprint server for health sciences · 2026
High stakes, low information, no roads: a qualitative evaluation of determinants of air ambulance utilization and decision making in rural Alaska.
СтатьяПрепринтНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Rice Brian, Berger Brandon A, Onders Robert, Medoff Sar, Saul Henry
Аннотация
BACKGROUND: In rural Alaska, where most communities lack road access, air ambulances serve as a critical link between remote communities and hospital services.
OBJECTIVE: To examine how air ambulance utilization decisions are made within the rural Alaskan health organization ecosystem.
METHODS: We conducted semi-structured interviews with five key stakeholders. Transcripts were analyzed thematically using the Practical, Robust Implementation and Sustainability Model (PRISM).
RESULTS: Four themes emerged that collectively define the structure of the air ambulance decision-making system, each reflecting interactions across multiple PRISM domains: limited formal guidance, logistical constraints affecting transport options, variability driven by communication and clinician risk tolerance, and reliance on unwritten rules. Together, these describe decision-making in a limited information state with incomplete feedback, leading to experiential and locally evolved practices.
CONCLUSION: Air ambulance use reflects clinical-logistical constraints rather than critical illness alone. Linking transport decisions to outcomes and developing structured decision support may improve consistency and optimize care delivery.
OBJECTIVE: To examine how air ambulance utilization decisions are made within the rural Alaskan health organization ecosystem.
METHODS: We conducted semi-structured interviews with five key stakeholders. Transcripts were analyzed thematically using the Practical, Robust Implementation and Sustainability Model (PRISM).
RESULTS: Four themes emerged that collectively define the structure of the air ambulance decision-making system, each reflecting interactions across multiple PRISM domains: limited formal guidance, logistical constraints affecting transport options, variability driven by communication and clinician risk tolerance, and reliance on unwritten rules. Together, these describe decision-making in a limited information state with incomplete feedback, leading to experiential and locally evolved practices.
CONCLUSION: Air ambulance use reflects clinical-logistical constraints rather than critical illness alone. Linking transport decisions to outcomes and developing structured decision support may improve consistency and optimize care delivery.