[Is the use of helicopters with a trauma team in severely injured accident victims in The Netherlands cost effective? A modelling approach].
OBJECTIVE
The assessment of the cost-effectiveness of helicopter medical crews for patients with major trauma in the Dutch situation.


METHODS
A modelling approach, combining available information with plausible assumptions.


METHODS
Institute for Medical Technology Assessment, Rotterdam.


METHODS
First, a baseline scenario was developed, implementing information that was available in the literature and a few assumptions. The sensitivity of the cost-effectiveness for the various assumptions was evaluated in alternative scenarios. END-POINTS. The relation between the costs per life year gained and the expected increase in the number of patients surviving an accident is established for the separate scenarios.


RESULTS
In the baseline scenario the number of victims with a trauma score < or = 12 is estimated at 4500 per year, it is assumed that victims who die at the scene of the accident are unsalvageable and that hospital treatment costs Dfl. 27,000.--per patient. As a result costs per life year saved are only under Dfl. 50,000.--when more than 29 patients per year (9.23% gain in survival) are additionally saved. Sensitivity analysis shows that the cost-effectiveness depends highly on the expected gain in survival and on the estimate of the costs of hospital treatment. Both variables are surrounded with a lot of uncertainty.


CONCLUSIONS
Relying on the information that is available at this moment, no definite conclusions can be drawn on the cost-effectiveness of this facility, because too many essential data are missing. Empirical research is necessary.
Michel
B C
BC
Erasmus Universiteit, Instituut Medische Technology Assessment, Rotterdam.
van Hout
B A
BA
D000401:Aircraft / Q000191:economics*; D003362:Cost-Benefit Analysis; D004632:Emergency Medical Services / Q000191:economics*; D006801:Humans; D009426:Netherlands; D014947:Wounds and Injuries / Q000191:economics* / Q000401:mortality / Q000628:therapy
Is het inzetten van helikopters met een traumateam bij ernstig gewonde ongevalsslachtoffers in Nederland kosteneffectief? Een modelmatige benadering.