OBJECTIVES: To assess the incremental consequences of the London Helicopter Emergency Medical Service (HEMS) for the outcomes of survivors in terms of disability and health status, and cost. METHODS: Prospective comparison of outcomes in cohorts of seriously injured patients attended either by the HEMS or by paramedically crewed land ambulances. In survivors, disability was assessed using an 11-point disability scale, and general health status was measured by the six dimensions of the 100-point Nottingham Health Profile (NHP) assessed 6 months after the injury. Costs were estimated for the HEMS and associated facilities at the Royal London Hospital, and the extra admissions attributable to the HEMS. RESULTS: There was no evidence of reduced disability in HEMS survivors (estimate: +0.8 disability grades worse; 95% CI: 0, 1.6), and no evidence of improvement in the six NHP dimensions scores or in the mean number of problems with seven aspects of daily living (estimated difference: +0.5; 95% CI: -0.2, 1.2). The incremental costs of HEMS were estimated to be 2.0 Pounds million a year. CONCLUSION: As there is no evidence of any improvement in outcomes overall for the extra cost, the HEMS has not been found to be a cost-effective service.
OBJECTIVES: To assess the incremental consequences of the London Helicopter Emergency Medical Service (HEMS) for the outcomes of survivors in terms of disability and health status, and cost. METHODS: Prospective comparison of outcomes in cohorts of seriously injured patients attended either by the HEMS or by paramedically crewed land ambulances. In survivors, disability was assessed using an 11-point disability scale, and general health status was measured by the six dimensions of the 100-point Nottingham Health Profile (NHP) assessed 6 months after the injury. Costs were estimated for the HEMS and associated facilities at the Royal London Hospital, and the extra admissions attributable to the HEMS. RESULTS: There was no evidence of reduced disability in HEMS survivors (estimate: +0.8 disability grades worse; 95% CI: 0, 1.6), and no evidence of improvement in the six NHP dimensions scores or in the mean number of problems with seven aspects of daily living (estimated difference: +0.5; 95% CI: -0.2, 1.2). The incremental costs of HEMS were estimated to be 2.0 Pounds million a year. CONCLUSION: As there is no evidence of any improvement in outcomes overall for the extra cost, the HEMS has not been found to be a cost-effective service.
Authors: M Frink; C Probst; F Hildebrand; M Richter; C Hausmanninger; B Wiese; C Krettek; H-C Pape Journal: Unfallchirurg Date: 2007-04 Impact factor: 1.000
Authors: M Kit Delgado; Kristan L Staudenmayer; N Ewen Wang; David A Spain; Sharada Weir; Douglas K Owens; Jeremy D Goldhaber-Fiebert Journal: Ann Emerg Med Date: 2013-04-09 Impact factor: 5.721
Authors: Brian P Walcott; Jean-Valery Coumans; Matthew K Mian; Brian V Nahed; Kristopher T Kahle Journal: PLoS One Date: 2011-10-12 Impact factor: 3.240