Cost-effectiveness and quality-of-life analysis of physician-staffed helicopter emergency medical services

• Published in: British journal of surgery Vol. 96; no. 11; pp. 1365 - 1370
• Main Authors: Ringburg, A. N., Polinder, S., Meulman, T. J., Steyerberg, E. W., van Lieshout, E. M. M., Patka, P., van Beeck, E. F., Schipper, I. B.
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01.11.2009; Wiley
• Subjects: Adult; Air Ambulances - economics; Air Ambulances - standards; Biological and medical sciences; Cohort Studies; Cost-Benefit Analysis; Emergency Medicine - economics; Emergency Medicine - standards; Emergency Treatment - economics; Emergency Treatment - mortality; Emergency Treatment - standards; Female; General aspects; Health participants; Humans; Male; Medical sciences; Middle Aged; Netherlands - epidemiology; Public health. Hygiene; Public health. Hygiene-occupational medicine; Quality of Health Care; Quality-Adjusted Life Years; Wounds and Injuries - economics; Wounds and Injuries - mortality; Wounds and Injuries - therapy; Netherlands; Human; Medicine; Helicopter; Treatment; Health staff; Surgery; Health economy; Health care staff; Physician; Emergency medical service; Cost efficiency analysis; Quality of life
• ISSN: 0007-1323; 1365-2168
• DOI: 10.1002/bjs.6720

Background: The long‐term health outcomes and costs of helicopter emergency medical services (HEMS) assistance remain uncertain. The aim of this study was to investigate the cost‐effectiveness of HEMS assistance compared with emergency medical services (EMS). Methods: A prospective cohort study was performed at a level I trauma centre. Quality‐of‐life measurements were obtained at 2 years after trauma, using the EuroQol—Five Dimensions (EQ‐5D) as generic measure to determine health status. Health outcomes and costs were combined into costs per quality‐adjusted life year (QALY). Results: The study population receiving HEMS assistance was more severely injured than that receiving EMS assistance only. Over the 4‐year study interval, HEMS assistance saved a total of 29 additional lives. No statistically significant differences in quality of life were found between assistance with HEMS or with EMS. Two years after trauma the mean EQ‐5D utility score was 0·70 versus 0·71 respectively. The incremental cost–effectiveness ratio for HEMS versus EMS was €28 327 per QALY. The sensitivity analysis showed a cost‐effectiveness ratio between €16 000 and €62 000. Conclusion: In the Netherlands, the costs of HEMS assistance per QALY remain below the acceptance threshold. HEMS should therefore be considered as cost effective. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Helicopter emergency medical services are considered cost‐effective