Overutilization of Helicopter Emergency Medical Services in Central Gulf Coast Region Results in Unnecessary Expenditure

Overutilization of Helicopter Emergency Medical Services in Central Gulf Coast Region Results in Unnecessary Expenditure

When appropriately used, helicopter emergency medical services (HEMSs) allow for timely delivery of severely injured patients to definitive care. Inappropriate utilization of HEMSs results in increased cost to the patient and trauma system. The purpose of this study was to review current HEMS criter...

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Bibliographic Details
Published in:The Journal of surgical research Vol. 273; pp. 211 - 217
Main Authors: Miles, M. Victoria P., Beasley, Justin R., Reed, Haylie E., Miles, Daniel T., Haiflich, Andrew, Beckett, Allison R., Lee, Yann-Leei, Bowden, Stephen E., Panacek, Edward A., Ding, Linda, Brevard, Sidney B., Simmons, Jon D., Butts, C. Caleb
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01-05-2022
Subjects:
Adult
Air Ambulances
Air medical transport
Aircraft
Emergency medical services
Emergency Medical Services - methods
EMS
Health Expenditures
Helicopter
Hemorrhage
Humans
Resource utilization
Retrospective Studies
Trauma Centers
Trauma systems
Wounds and Injuries - therapy
Helicopter
Resource utilization
EMS
Air medical transport
Trauma systems
Emergency medical services
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Summary:When appropriately used, helicopter emergency medical services (HEMSs) allow for timely delivery of severely injured patients to definitive care. Inappropriate utilization of HEMSs results in increased cost to the patient and trauma system. The purpose of this study was to review current HEMS criteria in the central Gulf Coast region and evaluate for potential areas of triage refinement and cost savings. We hypothesized that a significant number of patients received potentially unwarranted HEMS transport. A retrospective cohort study of all patients with trauma arriving to a level I trauma center by helicopter over 28 mo was performed; 381 patients with trauma and with HEMS transport from the scene were included. Data were collected from prehospital sources, as well as hospital chart review for each patient. The primary outcome was the rate of unwarranted HEMS transport. A total of 381 adult patients with trauma transported by the HEMS were analyzed, of which 34% were deemed potentially nonwarranted transports. The significant factors correlating with warranted HEMS transport included age, multiple long bone fractures, penetrating mechanism, and vehicle ejection. Insurance demographics did not correlate to transport modality. Many of these patients were transported from a location within the same county or the county adjacent to the trauma center. When comparing patients transported by ground and HEMSs from the same scene, no time savings were identified. Unwarranted transports at the trauma center represented an estimated health care expenditure of over $3 million. HEMSs may be overused in the central Gulf Coast region, creating the risk for a substantial resource and financial burden to the trauma system. Further collaboration is needed to establish HEMS triage criteria, that is, more appropriate use of resources.
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ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2021.12.038