COST-EFFECTIVENESS ANALYSIS OF HELICOPTER EMS FOR TRAUMA PATIENTS

Study objective: To evaluate the cost-effectiveness of helicopter EMS for trauma patients. Methods: We applied a cost-effectiveness analysis from the service provider's perspective to cost and effectiveness est imates. The cost estimates comprise direct operating costs and additio nal survivors' hospital costs. The effectiveness estimates were calcul ated with the TRISS methodology from literature sources and data from a cohort of patients transported by helicopter during 1994 and 1995. S ensitivity analysis and discounting were used. Cost per life saved and discounted cost per year of life in 1995 US dollars were the main out come measures. Results: The reported literature survival benefit range s from 1 to 12 additional survivors per 100 patients flown. Transport costs were $2,214 per patient, and each additional survivor's hospital ization averaged $15,883. For the base case (5 additional survivors pe r 100 patients flown), cost per life was $60,163 and discounted cost p er year of life $2,454. Sensitivity analysis revealed that discounted cost per year of life could be as high as $9,677 or as low as $1,400 a nd that it was most dependent on the survival benefit. These results a re comparable to a reported median discounted cost per year of life of $19,000 for other commonly used lifesaving medical interventions. Con clusion: Assuming that helicopter air medical transport provides a sub stantial survival benefit for trauma patients, our findings suggest th at this service is a cost-effective option for the treatment of trauma patients. The magnitude of the survival benefit is the most important factor determining cost-effectiveness.