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A scenario based approach to optimizing cost-effectiveness of physician-staffed Helicopter Emergency Medical Services compared to ground-based Emergency Medical Services in Finland.
Ackermann, Axel; Pappinen, Jukka; Nurmi, Jouni; Nordquist, Hilla; Saviluoto, Anssi; Mannila, Santtu; Mäkelä, Simo; Torkki, Paulus.
Afiliación
  • Ackermann A; Department of Public Health, Faculty of Medicine, University of Helsinki, P.O. BOX 00020, Helsingin Yliopisto, Helsinki, 00014, Finland. axel.ackermann@helsinki.fi.
  • Pappinen J; Department of Public Health, Faculty of Medicine, University of Helsinki, P.O. BOX 00020, Helsingin Yliopisto, Helsinki, 00014, Finland.
  • Nurmi J; Helsinki University Hospital and University of Helsinki, Acute, Medical Helicopter FinnHEMS 10, Vesikuja 9, Vantaa, 01530, Finland.
  • Nordquist H; FinnHEMS Oy, c/o Avia Pilot, Lentäjäntie 3, Vantaa, 01530, Finland.
  • Saviluoto A; South-Eastern Finland University of Applied Sciences, Department of Healthcare and Emergency care, Pääskysentie 1, Kotka, 48220, Finland.
  • Mannila S; Emergency Medicine and Services, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
  • Mäkelä S; Copterpoint Oy, Vähäniityntie 18B, Helsinki, 00570, Finland.
  • Torkki P; Data Science, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Scand J Trauma Resusc Emerg Med ; 32(1): 60, 2024 Jul 02.
Article en En | MEDLINE | ID: mdl-38956713
ABSTRACT

OBJECTIVES:

Since Helicopter Emergency Medical Services (HEMS) is an expensive resource in terms of unit price compared to ground-based Emergency Medical Service (EMS), it is important to further investigate which methods would allow for the optimization of these services. The aim of this study was to evaluate the cost-effectiveness of physician-staffed HEMS compared to ground-based EMS in developed scenarios with improvements in triage, aviation performance, and the inclusion of ischemic stroke patients.

METHODS:

Incremental cost-effectiveness ratio (ICER) was assessed by comparing health outcomes and costs of HEMS versus ground-based EMS across six different scenarios. Estimated 30-day mortality and quality-adjusted life years (QALYs) were used to measure health benefits. Quality-of-Life (QoL) was assessed with EuroQoL instrument, and a one-way sensitivity analysis was carried out across different patient groups. Survival estimates were evaluated from the national FinnHEMS database, with cost analysis based on the most recent financial reports.

RESULTS:

The best outcome was achieved in Scenario 3.1 which included a reduction in over-alerts, aviation performance enhancement, and assessment of ischemic stroke patients. This scenario yielded 1077.07-1436.09 additional QALYs with an ICER of 33,703-44,937 €/QALY. This represented a 27.72% increase in the additional QALYs and a 21.05% reduction in the ICER compared to the current practice.

CONCLUSIONS:

The cost-effectiveness of HEMS can be highly improved by adding stroke patients into the dispatch criteria, as the overall costs are fixed, and the cost-effectiveness is determined based on the utilization rate of capacity.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Análisis Costo-Beneficio / Ambulancias Aéreas / Servicios Médicos de Urgencia Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Scand J Trauma Resusc Emerg Med Asunto de la revista: MEDICINA DE EMERGENCIA / TRAUMATOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Finlandia Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Análisis Costo-Beneficio / Ambulancias Aéreas / Servicios Médicos de Urgencia Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Scand J Trauma Resusc Emerg Med Asunto de la revista: MEDICINA DE EMERGENCIA / TRAUMATOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Finlandia Pais de publicación: Reino Unido