In Finland, helicopter emergency medical services (HEMS) staffed by physicians have sparked interest due to their higher unit costs compared to traditional ground-based emergency medical services (EMS). This study delves into the cost-effectiveness of HEMS, evaluating its impact under current operational practices. By analyzing differences in outcomes and costs, the study aims to provide a comprehensive understanding of HEMS’s economic and health benefits.
The study employs the incremental cost-effectiveness ratio (ICER) to compare HEMS with ground-based EMS. Health benefits are measured through estimated 30-day mortality rates and quality-adjusted life years (QALYs). Using the EuroQoL scale, the quality of life is estimated, and a one-way sensitivity analysis is conducted on QALY indexes ranging from 0.6 to 0.8. The national HEMS database offers survival rate data, while financial statements estimate the cost structure at 48 million euros.
Survival and Cost Analysis
HEMS is shown to prevent the 30-day mortality of 68.1 patients annually. The ICER for HEMS ranges between €43,688 and €56,918 per QALY. Fixed costs are a significant component, representing 93% of total HEMS expenses due to round-the-clock operations. Consequently, the capacity utilization rate emerges as a crucial factor influencing total costs.
Quality of Life and Sensitivity Analysis
Quality of life, assessed using the EuroQoL scale, provides a nuanced perspective on health benefits. The sensitivity analysis, with QALY indexes between 0.6 and 0.8, underscores the robustness of the findings, demonstrating that HEMS’s cost-effectiveness remains consistent across different quality-of-life scenarios. The study’s approach highlights the importance of evaluating health outcomes comprehensively.
Key Inferences
– HEMS significantly reduces 30-day mortality rates.
– The cost per QALY for HEMS is within an acceptable range, supporting its cost-effectiveness.
– Fixed costs dominate the expense structure, emphasizing the need for efficient utilization.
– Sensitivity analysis validates the resilience of the cost-effectiveness findings across various quality-of-life measures.
In conclusion, the study affirms that HEMS is a cost-effective alternative to ground-based EMS, aligning with societal willingness to pay. These insights are pivotal for healthcare management decisions and underscore the necessity of future research aimed at optimizing HEMS services.
Original Article:
Air Med J. 2024 May-Jun;43(3):229-235. doi: 10.1016/j.amj.2023.12.006. Epub 2024 Jan 4.
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