Talk about trying to do something with old and inconclusive evidence.
A brief (well it is 7am and I'm having breakfast) search of some academic journals for "HEMS Cost Effectiveness" comes out with 400 ish responses. I'll look a bit more later but, for instance....for HEMS in Holland, (not a country noted for its remote terrain or great distances between cities.)
Results:
The study population receiving HEMS assistance was more severely injured than that receiving EMS assistance only. Over the 4-year study interval, HEMS assistance saved a total of 29 additional lives. No statistically significant differences in quality of life were found between assistance with HEMS or with EMS. Two years after trauma the mean EQ-5D utility score was 0·70 versus 0·71 respectively. The incremental cost–effectiveness ratio for HEMS versus EMS was €28 327 per QALY. The sensitivity analysis showed a cost-effectiveness ratio between €16 000 and €62 000.
Conclusion:
In the Netherlands, the costs of HEMS assistance per QALY remain below the acceptance threshold. HEMS should therefore be considered as cost effective.
Polinder et al in the British Journal of Surgery Society Ltd Vol 96 Issue 11. Published by John Wiley & Sons, Ltd.
That said the attempts at a meta analysis are thwarted by the great diversity of what HEMS actually IS.
From "A systematic review of the costs and benefits of helicopter emergency medical services" in Injury (Vol 41 Issue 1)
the cost and effectiveness of HEMS varied considerably between studies. Despite generally being more expensive than ground transport, a number of studies found HEMS to be cost-effective. However, given the variation in the intervention design, context and study methods between studies it was not possible to assess the cost–effectiveness of HEMS in general. Given the variation inherent in the health systems in which HEMS operate, synthesis and extrapolation of study findings across differing health environments is difficult. To address economic and clinical evidence in relation to HEMS, future research that is tailored to account for local system factors is required.
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