Hostname: page-component-84b7d79bbc-lrf7s Total loading time: 0 Render date: 2024-07-29T02:01:10.808Z Has data issue: false hasContentIssue false
  • English
  • Français

Comparative Study on the Outcome of Trauma Patients Transferred by Doctor Helicopters and Ground Ambulance in South Korea

Published online by Cambridge University Press:  14 November 2022

Kang Hyun Lee Open the ORCID record for Kang Hyun Lee [Opens in a new window]  and
Jeong Il Lee Open the ORCID record for Jeong Il Lee [Opens in a new window]
Kang Hyun Lee
Affiliation:
Wonju College of Medicine, Yonsei University, Republic of Korea
Jeong Il Lee*
Affiliation:
National Civil Defense and Disaster Management Training Institute, Republic of Korea
*
Corresponding author: Jeong Il Lee, Email: promise2527@naver.com.
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

The purpose of this study was to analyze the cost-effectiveness of helicopter emergency medical services (HEMS) for its economic operations in South Korea.

Methods:

This study targeted trauma patients that were transported by either HEMS or ground emergency medical services (GEMS) from the scene of an accident to a regional emergency medical center. From this patient population, severe trauma patients (injury severity score ISS ≥ 16 points) with a distance travelled from the scene of the injury to the hospital that was 30 km or longer and with analyzable outcome data were extracted and included in this study. Cost-effectiveness was analyzed from survival and efficiency based on medical costs incurred from the pre-hospital setting to hospital discharge. This study included a total of 34 HEMS and 105 GEMS patients with an Injury Severity Score (ISS) ≥ 16 points from a pool of 357 potential patients.

Results:

The survival-to-discharge rate of HEMS was 29 of 34 patients (85.3%) and was significantly higher than that of GEMS, where only 66 of 105 patients (62.8%) survived to discharge (P = 0.024). The expected and the actual mortality was higher in HEMS than it was in GEMS. Statistical significant difference in cost was found between the 2 groups (P = 0.002).

Conclusions:

The results of the present study indicate the increased discharge rate, survival rate and reduced in hospital mortality of HEMS with reduced admission time. This result association leads to reasonable cost effectiveness and efficient estimates overall.

Keywords

Helicopter Emergency Medical Services (HEMS)Ground Emergency Medical Services (GEMS)EMStraumaprehospital care
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 17 , 2023 , e290
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Thomas, SH. Helicopter emergency medical services transport outcomes literature: annotated review of articles published 2000-2003. Prehosp Emerg Care. 2004;8(3):322-333.Google ScholarPubMed
Phillips, M, Arthur, AO, Chandwaney, R, et al. Helicopter transport effectiveness of patients for primary percutaneous coronary intervention. Air Med J. 2013;32(3):144-152.CrossRefGoogle ScholarPubMed
Cunningham, P, Rutledge, R, Baker, CC, et al. A comparison of the association of helicopter and ground ambulance transport with the outcome of injury in trauma patients transported from the scene. J Trauma. 1997;43(6):940-946.CrossRefGoogle ScholarPubMed
Baxt, WG, Moody, P. The impact of a physician as part of the aeromedical prehospital team in patients with blunt trauma. JAMA. 1987;257(23):3246-3250.Google ScholarPubMed
Lee, CY, Cho, JS, Yang, HJ, et al. Present situation of helicopter emergency medical services in South Korea during the first year. J Korean Soc Emerg Med. 2014;25(1):60-68.Google Scholar
Thomas, SH, Biddinger, PD. Helicopter trauma transport: an overview of recent outcomes and triage literature. Curr Opin Anaesthesiol. 2003;16(2):153-158.CrossRefGoogle ScholarPubMed
Taylor, CB, Stevenson, M, Jan, S, et al. A systematic review of the costs and benefits of helicopter emergency medical services. Injury. 2010;41(1):10-20.CrossRefGoogle ScholarPubMed
Thomas, SH. Helicopter EMS transport outcomes literature: annotated review of articles published 2004-2006. Prehosp Emerg Care. 2007;11(4):477-488.CrossRefGoogle Scholar
Boyd, CR, Tolson, MA, Copes, WS. Evaluating trauma care: the TRISS method. J Trauma. 1987;27(4):370-378.CrossRefGoogle ScholarPubMed
Singh, J, Gupta, G, Garg, R, et al. Evaluation of trauma and prediction of outcome using TRISS method. J Emerg Trauma Shock. 2011;4(4):446-49.Google ScholarPubMed
Delgado, MK, Staudenmayer, KL, Wang, NE, et al. Cost-effectiveness of helicopter versus ground emergency medical services for trauma scene transport in the United States. Ann Emerg Med. 2013;62(4):351-364.CrossRefGoogle ScholarPubMed
Taylor, CB, Stevenson, M, Jan, S, et al. A systematic review of the costs and benefits of helicopter emergency medical services. Injury. 2010;41(1):10-20.CrossRefGoogle ScholarPubMed
Moher, D, Pham, B, Jones, A, et al. Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta-analyses? Lancet. 1998;352(9128):609-613.CrossRefGoogle ScholarPubMed
Gearhart, PA, Wuerz, R, Localio, AR. Cost-effectiveness analysis of helicopter EMS for trauma patients. Ann Emerg Med. 1997;30(4):500-506.CrossRefGoogle ScholarPubMed
Brown, BS, Pogue, KA, Williams, E, et al. Helicopter EMS transport outcomes literature: annotated review of articles published 2007-2011. Emerg Med Int. 2012;2012:876703.Google Scholar
Park, JH, Shin, SD, Lee, EJ, et al. Physician-staffed helicopter transport for mountain-rescued emergency patients. J Trauma Inj. 2012;25(4):230-240 Google Scholar
Duke, JH Jr, Clarke, WP. A university-staffed, private hospital-based air transport service: the initial two-year experience. Arch Surg. 1981;116(5):703-708.CrossRefGoogle ScholarPubMed
Wigman, LD, van Lieshout, EM, de Ronde, G, et al. Trauma-related dispatch criteria for helicopter emergency medical services in Europe. Injury. 2011;42(5):525-533.CrossRefGoogle ScholarPubMed
Benson, NH. Air medical transport financial literature. Hosp Aviat. 1989;8(5):15-18.CrossRefGoogle Scholar
Moore, L. Measuring quality and effectiveness of prehospital EMS. Prehosp Emerg Care. 1999;3(4):325-331.CrossRefGoogle ScholarPubMed
Ringburg, AN, de Ronde, G, Thomas, SH, et al. Validity of helicopter emergency medical services dispatch criteria for traumatic injuries: a systematic review. Prehosp Emerg Care. 2009;13(1):28-36.CrossRefGoogle ScholarPubMed
Galvagno, SM Jr, Thomas, S, Stephens, C, et al. Helicopter emergency medical services for adults with major trauma. Cochrane Database Syst Rev. 2013;3:CD009228.Google Scholar
Black, JJ, Ward, ME, Lockey, DJ. Appropriate use of helicopters to transport trauma patients from incident scene to hospital in the United Kingdom: an algorithm. Emerg Med J. 2004;21(3):355-361.CrossRefGoogle ScholarPubMed
Abe, T, Takahashi, O, Saitoh, D, et al. Association between helicopter with physician versus ground emergency medical services and survival of adults with major trauma in Japan. Crit Care. 2014;18(4):R146 CrossRefGoogle ScholarPubMed
Branas, CC, MacKenzie, EJ, Williams, JC, et al. Access to trauma centers in the United States. JAMA. 2005;293(21):2626-2633.CrossRefGoogle ScholarPubMed
Galvagno, SM Jr, Haut, ER, Zafar, SN, et al. Association between helicopter vs ground emergency medical services and survival for adults with major trauma. JAMA. 2012;307(15):1602-1610.CrossRefGoogle ScholarPubMed
Cutler, DM, Rosen, AB, Vijan, S. The value of medical spending in the United States, 1960-2000. N Engl J Med. 2006;355(9):920-927.CrossRefGoogle ScholarPubMed
Braithwaite, RS, Meltzer, DO, King, JT Jr, et al. What does the value of modern medicine say about the $50,000 per quality-adjusted life-year decision rule? Med Care. 2008;46(4):349-356.CrossRefGoogle ScholarPubMed
Kutzin, J. A descriptive framework for country-level analysis of health care financing arrangements. Health Policy. 2001;56(3):171-204.CrossRefGoogle ScholarPubMed