Cost-Effectiveness Analysis of Helicopter EMS for Trauma Patients☆,☆☆
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INTRODUCTION
Trauma is a major public health concern in the United States. Often affecting the young, trauma can result in significant health care expenditures, lost wages, and disability.1 Trauma care systems, although expensive, save many years of life and enable many trauma victims to return to the workplace.2 For more than 25 years, helicopter ambulances have been a part of organized trauma systems in the United States. Helicopter programs were estimated to cost $250 million in 1991,3 but no formal
MATERIALS AND METHODS
We estimated cost-effectiveness using commonly accepted standards.4, 5, 6 Trauma was chosen because it is the most well-accepted indication for helicopter transport,7 and the service provider's perspective was used. The larger societal perspective was not used because data on lost wages and long-term disability attributable to trauma are difficult to estimate. Also, “costs,” as represented by the amount charged to patients and insurers, seldom reflect the actual costs of providing the service.
RESULTS
The direct operating costs totaled $2,253,952 per year, as follows: $1,197,115 (53%) personnel, $491,081 (22%) capital, $296,796 (13%) operations, $134,942 (6%) insurance, $118,332 (5%) administration, and $15,685 (<1%) medical supplies. The total number of helicopter transports in 1995 was 1,018, which yielded an average cost per patient transport of $2,214. The expected hospital reimbursement for a trauma survivor (used to estimate hospital costs) averaged $15,883 (range, $2,722 to $64,526).
DISCUSSION
The findings of this analysis of helicopter air medical programs for trauma patients contradict the widely held perception that these programs are not cost-effective. It is tempting to equate low costs with cost-effectiveness (and high costs with cost-prohibitiveness); however, an explicit cost-effectiveness study can avert false conclusions. For example, thrombolytic treatment with tissue plasminogen activator in acute myocardial infarction has a survival benefit of a magnitude similar to that
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Aeromedical helicopter transport of prisoners: The Mexico City experience
2021, American Journal of Emergency MedicineSurvival benefit of physician-staffed Helicopter Emergency Medical Services (HEMS) assistance for severely injured patients
2015, InjuryCitation Excerpt :Expressed as lives saved per 100 dispatches, HEMS assistance results in an average of 5.33 lives saved per 100 HEMS dispatches for severely injured patients. In the literature, the number of lives saved per 100 HEMS dispatches has been reported to range from 1.1 to 19 [5,13,15,23]. Because of the great variety in study design, geographical settings (rural versus urban), organisation of the trauma systems, type of pre-hospital trauma care (physician, nurse, EMS, HEMS), study population (blunt versus penetrating trauma), and definition of mortality (i.e., in-hospital mortality or mortality in a specific time frame), it is difficult to compare our results with previously published international studies.
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From the College of Medicine,* the Center for Emergency Medical Services,‡ and the Center for Biostatistics and Epidemiology,§ Pennsylvania State University College of Medicine, Hershey, PA.
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Reprint no.47/1/84406