Literature DB >> 25710420

Overuse of helicopter transport in the minimally injured: A health care system problem that should be corrected.

Gary A Vercruysse1, Randall S Friese, Mazhar Khalil, Irada Ibrahim-Zada, Bardiya Zangbar, Ammar Hashmi, Andrew Tang, Terrence O'Keeffe, Narong Kulvatunyou, Donald J Green, Lynn Gries, Bellal Joseph, Peter M Rhee.   

Abstract

BACKGROUND: Mortality benefit has been demonstrated for trauma patients transported via helicopter but at great cost. This study identified patients who did not benefit from helicopter transport to our facility and demonstrates potential cost savings when transported instead by ground.
METHODS: We performed a 6-year (2007-2013) retrospective analysis of all trauma patients presenting to our center. Patients with a known mode of transfer were included in the study. Patients with missing data and those who were dead on arrival were excluded from the study. Patients were then dichotomized into helicopter transfer and ground transfer groups. A subanalysis was performed between minimally injured patients (ISS < 5) in both the groups after propensity score matching for demographics, injury severity parameters, and admission vital parameters. Groups were then compared for hospital and emergency department length of stay, early discharge, and mortality.
RESULTS: Of 5,202 transferred patients, 18.9% (981) were transferred via helicopter and 76.7% (3,992) were transferred via ground transport. Helicopter-transferred patients had longer hospital (p = 0.001) and intensive care unit (p = 0.001) stays. There was no difference in mortality between the groups (p = 0.6).On subanalysis of minimally injured patients there was no difference in hospital length of stay (p = 0.1) and early discharge (p = 0.6) between the helicopter transfer and ground transfer group. Average helicopter transfer cost at our center was $18,000, totaling $4,860,000 for 270 minimally injured helicopter-transferred patients.
CONCLUSION: Nearly one third of patients transported by helicopter were minimally injured. Policies to identify patients who do not benefit from helicopter transport should be developed. Significant reduction in transport cost can be made by judicious selection of patients. Education to physicians calling for transport and identification of alternate means of transportation would be both safe and financially beneficial to our system. LEVEL OF EVIDENCE: Epidemiologic study, level III. Therapeutic study, level IV.

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Year:  2015        PMID: 25710420     DOI: 10.1097/TA.0000000000000553

Source DB:  PubMed          Journal:  J Trauma Acute Care Surg        ISSN: 2163-0755            Impact factor:   3.313


  7 in total

1.  Value Utilization of Emergency Medical Services Air Transport in Acute Ischemic Stroke.

Authors:  Amelia K Adcock; Joseph Minardi; Scott Findley; Deb Daniels; Michelle Large; Martha Power
Journal:  J Emerg Med       Date:  2020-10-01       Impact factor: 1.484

2.  Outcomes after helicopter versus ground emergency medical services for major trauma--propensity score and instrumental variable analyses: a retrospective nationwide cohort study.

Authors:  Asuka Tsuchiya; Yusuke Tsutsumi; Hideo Yasunaga
Journal:  Scand J Trauma Resusc Emerg Med       Date:  2016-11-29       Impact factor: 2.953

3.  Applying Supervised Machine Learning to Identify Which Patient Characteristics Identify the Highest Rates of Mortality Post-Interhospital Transfer.

Authors:  Andrew P Reimer; Nicholas K Schiltz; Vanessa P Ho; Elizabeth A Madigan; Siran M Koroukian
Journal:  Biomed Inform Insights       Date:  2019-03-18

4.  Association of Pre-Hospital Helicopter Transport with Reduced Mortality in Traumatic Brain Injury in Japan: A Nationwide Retrospective Cohort Study.

Authors:  Sanae Hosomi; Tetsuhisa Kitamura; Tomotaka Sobue; Yuko Nakagawa; Hiroshi Ogura; Takeshi Shimazu
Journal:  J Neurotrauma       Date:  2021-12-01       Impact factor: 5.269

5.  The introduction of a regional Norwegian HEMS coordinator: an assessment of the effects on response times, geographical service areas and severity scores.

Authors:  Ole Erik Ulvin; Eivinn Årdal Skjærseth; Helge Haugland; Kjetil Thorsen; Trond Nordseth; Marie Falch Orre; Lars Vesterhus; Andreas Jørstad Krüger
Journal:  BMC Health Serv Res       Date:  2022-08-10       Impact factor: 2.908

6.  Time-saving effects using helicopter transportation: comparison to a ground transportation time predicted using a social navigation software.

Authors:  Ji Young Jang; Woo-Keun Kwon; Haewon Roh; Jong Ha Moon; Jun Seong Hwang; Yoon Jic Kim; Jang Hun Kim
Journal:  Medicine (Baltimore)       Date:  2021-07-09       Impact factor: 1.817

7.  Association of Interfacility Helicopter versus Ground Ambulance Transport and in-Hospital Mortality among Trauma Patients.

Authors:  Kenneth Stewart; Tabitha Garwe; Babawale Oluborode; Zoona Sarwar; Roxie M Albrecht
Journal:  Prehosp Emerg Care       Date:  2020-10-05       Impact factor: 2.686

  7 in total

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