Interfacility helicopter ambulance transport of neurosurgical patients

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 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 of all interfacility helicopter transfers of neurosurgical patients to a single 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 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 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 for interfacility hospital transfer – a practice that is costly and has been increasingly utilized."

More information: 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

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