Doctors may be sending too many patients by helicopter, an expensive choice that may not impact patient outcome
When a patient needs to travel between hospitals and time is of the essence, helicopter transport is generally assumed to be faster and more desirable than taking a ground ambulance, but a paper published today in the online journal PLoS ONE refutes this common assumption, revealing that the actual times to treatment for patients transported by helicopter may not justify the expense relative to ground ambulances.
The researchers conducted a retrospective analysis of all interfacility helicopter transfers of neurosurgical patients to a single trauma center in 2008 and determined the actual time to intervention at the receiving hospital.
They then compared these times to an estimated time required for ground transportation between the two facilities. They found that 60% of the 167 transferred patients included in the study were at institutions within an estimated driving time of less than an hour. For these patients, they argue, it is not clear that the helicopter transport was superior to a traditional ambulance.
The authors also point out that 63% of the transferred patients considered in the study did not need immediate intervention and could have been stabilized at the original hospital before transfer by ground ambulance.
Therefore, given that patient transport by helicopter can cost up to $25,000, while ground transport is estimated to cost much less (between $800 and $2,000), the authors conclude that doctors may want to reevaluate their assumptions about patient helicopter transport.
"In an area of rising healthcare costs and expenditure scrutiny, it is necessary to make evidence-based decisions to optimize patient care in an efficient way," says Dr. Brian Walcott of Harvard Medical School and the Massachusetts General Hospital, who led the research. "This study provides preliminary data that brings into question the efficacy of helicopter transport for interfacility hospital transfer – a practice that is costly and has been increasingly utilized."
Citation: Walcott BP, Coumans J-V, Mian MK, Nahed BV, Kahle KT (2011) Interfacility Helicopter Ambulance Transport of Neurosurgical Patients: Observations, Utilization, and Outcomes from a Quaternary Level Care Hospital. PLoS ONE 6(10): e26216. doi:10.1371/journal.pone.0026216
Financial Disclosure: This work was conducted with support from Harvard Catalyst | The Harvard Clinical and Translational Science Center (National Institutes of Health Award #UL1 RR 025758 and financial contributions from Harvard University and its affiliated academic health care centers). The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard Catalyst, Harvard University and its affiliated academic health care centers, the National Center for Research Resources, or the National Institutes of Health. Additional research support was provided using departmental research funds from the Massachusetts General Hospital, Department of Neurosurgery. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing Interest Statement: The authors have declared that no competing interests exist.
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