Abstract
Background and context
Helicopter Emergency Medical Services (HEMS) have been incorporated into modern health
systems for their speed and coverage. In the state of New South Wales (NSW), nine
HEMS operate from various locations around the state and currently there is no clear
picture of their resource implications. The aim of this study was to assess the cost
of HEMS in NSW and investigate the factors linked with the variation in the costs,
coverage and activities of HEMS.
Methods
We undertook a survey of HEMS costs, structures and operations in NSW for the 2008/2009
financial year. Costs were estimated from annual reports and contractual agreements.
Data related to the structure and operation of services was obtained by face-to-face
interviews, from operational data extracted from individual HEMS, from the NSW Ambulance
Computer Aided Despatch system and from the Aeromedical Operations Centre database.
In order to estimate population coverage for each HEMS, we used GIS mapping techniques
with Australian Bureau of Statistics census information.
Results
Across HEMS, cost per mission estimates ranged between $9300 and $19,000 and cost
per engine hour estimates ranged between $5343 and $15,743. Regarding structural aspects,
six HEMS were run by charities or not-for-profit companies (with partial government
funding) and three HEMS were run (and fully funded) by the state government through
NSW Ambulance. Two HEMS operated as ‘hub’ services in conjunction with three associated
‘satellite’ services and in contrast, four services operated independently. Variation
also existed between the HEMS in the type of helicopter used, the clinical staffing
and the hours of operation. The majority of services undertook both primary scene
responses and secondary inter-facility transfers, although the proportion of each
type of transport contributing to total operations varied across the services.
Interpretation
This investigation highlighted the cost of HEMS operations in NSW which in total equated
to over $50 million per annum. Across services, we found large variation in the cost
estimates which was underscored by variation in the structure and operations of HEMS.
Keywords
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Article info
Publication history
Accepted:
February 18,
2011
Identification
Copyright
© 2011 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
