Format

Send to

Choose Destination
Ann Emerg Med. 2013 Oct;62(4):351-364.e19. doi: 10.1016/j.annemergmed.2013.02.025. Epub 2013 Apr 9.

Cost-effectiveness of helicopter versus ground emergency medical services for trauma scene transport in the United States.

Author information

1
Department of Surgery, Division of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA; Center for Health Policy and Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Palo Alto, CA; Stanford Investigators for Surgery, Trauma, and Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA. Electronic address: kit.delgado@uphs.upenn.edu.

Erratum in

  • Ann Emerg Med. 2014 Apr;63(4):411.

Abstract

STUDY OBJECTIVE:

We determine the minimum mortality reduction that helicopter emergency medical services (EMS) should provide relative to ground EMS for the scene transport of trauma victims to offset higher costs, inherent transport risks, and inevitable overtriage of patients with minor injury.

METHODS:

We developed a decision-analytic model to compare the costs and outcomes of helicopter versus ground EMS transport to a trauma center from a societal perspective during a patient's lifetime. We determined the mortality reduction needed to make helicopter transport cost less than $100,000 and $50,000 per quality-adjusted life-year gained compared with ground EMS. Model inputs were derived from the National Study on the Costs and Outcomes of Trauma, National Trauma Data Bank, Medicare reimbursements, and literature. We assessed robustness with probabilistic sensitivity analyses.

RESULTS:

Helicopter EMS must provide a minimum of a 15% relative risk reduction in mortality (1.3 lives saved/100 patients with the mean characteristics of the National Study on the Costs and Outcomes of Trauma cohort) to cost less than $100,000 per quality-adjusted life-year gained and a reduction of at least 30% (3.3 lives saved/100 patients) to cost less than $50,000 per quality-adjusted life-year. Helicopter EMS becomes more cost-effective with significant reductions in patients with minor injury who are triaged to air transport or if long-term disability outcomes are improved.

CONCLUSION:

Helicopter EMS needs to provide at least a 15% mortality reduction or a measurable improvement in long-term disability to compare favorably with other interventions considered cost-effective. Given current evidence, it is not clear that helicopter EMS achieves this mortality or disability reduction. Reducing overtriage of patients with minor injury to helicopter EMS would improve its cost-effectiveness.

PMID:
23582619
PMCID:
PMC3999834
DOI:
10.1016/j.annemergmed.2013.02.025
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center