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Lääkintähelikopterin vaikuttavuuden arviointi
- Author(s):
- Terveydenhuollon menetelmien arviointiyksikkö (Finland)
- Finland Sosiaali- ja terveysalan tutkimus- ja kehittämiskeskus
- Title(s):
- Lääkintähelikopterin vaikuttavuuden arviointi / Terveydenhuollon menetelmien arviointiyksikkö (Finland).
- Series:
- FinOHTA report, ; no. 12 ISSN 1239-6273
- Country of Publication:
- Finland
- Publisher:
- Helsinki, Finland : Finnish Office for Health Care Technology Assessment (FinOHTA), 2000.
- Description:
- 46 p. : ill.
-
Language:
- Finnish
-
Other Languages:
- English(Summary)
- ISBN:
- 9789513305260
9513305260
- Summary:
- Although helicopter emergency medical services have been studied in many countries, unanimous scientific evidence on their effectiveness that would be applicable to Finnish conditions is still lacking. Consequently, FinOHTA decided in 1999 to evaluate the effectiveness and cost-effectiveness of two Finnish models for providing helicopter emergency services. The evaluation was done on 1) a rescue helicopter service based in the city of Varkaus, staffed by a flight paramedic and 2) a helicopter emergency service operating from the city of Turku, staffed by a flight physician. The benefits for patient outcome were evaluated by an external four-member panel consisting of physicians representing four different medical specialities. Of all emergency calls in the year 1998, the local service providers pre-selected for panel evaluation the cases in which they considered the helicopter rescue service to have possibly been of benefit for the patients. This approach was taken because of the urgent need for information and because of the methodological problems associated with a more rigorous study design. In addition to the results of the evaluation, this report also contains a review of the existing literature on the topic and a health economic analysis. If the effectiveness of helicopter emergency medical services is judged solely on the basis of their ability to save lives, the physician-staffed service was more effective than the paramedic-staffed service: the physician-staffed service had a life-saving influence in 8.8 % of the pre-selected cases, the paramedic-staffed service in 3.7 % of the cases. When all the cases where helicopter service was deemed to have been of importance for the survival of the patients are taken into consideration, the physician-staffed service was, depending on the classification used, instrumental to the survival of the patients in 48 % to 62 % of the cases and the paramedic-staffed service in 13 % to 22 % of the cases. When these figures are related to the total number of emergency calls (not just the number of pre-selected cases) the numbers of those having gained benefit are naturally smaller: 6.8 % to 8.7 % for the physician-staffed service cases and 4.1 % to 6.5 % for the paramedic-staffed service cases. The difference between the two alternative ways of providing the service is diminished. Even these figures, however, point to the fact that the physician-staffed service was more effective than the paramedic-staffed service. Due to many uncertainties, it is not possible to give precise figures about the cost-effectiveness of either model for organising helicopter emergency services. However, according to a rough estimate, the cost of a life-year saved varied between FIM 19 000 and FIM 1 146 000 (EUR 3 195 and EUR 192 743) for the physician-staffed service and between FIM 42 500 and FIM 3 144 000 (EUR 7 147 and EUR 528 782) for the paramedic-staffed service. If one takes into account also emergency calls attended only by the land ambulance of the physician-staffed emergency service, the cost of a life-year saved varied between FIM 10 917 and FIM 655 000 (EUR 1 715 and EUR 110 163). In both studied models the costs are most likely closer to the lower than the higher end of the variation. Thus the cost-effectiveness of emergency helicopter medical services appears to be in the same range as that found for, for example, mammography screening, or dialysis treatment of renal impairment. The results concerning the effectiveness of the emergency medical helicopter services evaluated in this report have to be considered indicative as there are many uncertainties related to the field. The strength of the evidence is also limited by the fact that the studied patient material was in both cases fairly small and that the service was not yet fully established in either case. Furthermore, the present study does not allow for conclusions about the effectiveness of different models of providing emergency services. Further studies are thus clearly needed. Decisions about how to organise helicopter emergency medical services have to be based on data on the effectiveness of various models. In addition, other matters such as the equity of services for citizens and possible co-operation with other helicopter service providers have to be taken into account. There is also a clear need for a public debate on how to organise services. Although our study has limitations, it helps to form a solid basis for this debate.
- MeSH:
- Emergency Medical Services.*
Finland
Technology Assessment, Biomedical*
- Publication Type(s):
- Technical Report
- Notes:
- Includes bibliographical references.
38 ref.
- NLM ID:
- 101088413 [Book]