The cost and effectiveness of the London Helicopter Emergency Medical Service.
OBJECTIVE
To assess the incremental consequences of the London Helicopter Emergency Medical Service (HEMS) for the outcomes of survivors in terms of disability and health status, and cost.


METHODS
Prospective comparison of outcomes in cohorts of seriously injured patients attended either by the HEMS or by paramedically crewed land ambulances. In survivors, disability was assessed using an 11-point disability scale, and general health status was measured by the six dimensions of the 100-point Nottingham Health Profile (NHP) assessed 6 months after the injury. Costs were estimated for the HEMS and associated facilities at the Royal London Hospital, and the extra admissions attributable to the HEMS.


RESULTS
There was no evidence of reduced disability in HEMS survivors (estimate: +0.8 disability grades worse; 95% CI: 0, 1.6), and no evidence of improvement in the six NHP dimensions scores or in the mean number of problems with seven aspects of daily living (estimated difference: +0.5; 95% CI: -0.2, 1.2). The incremental costs of HEMS were estimated to be 2.0 Pounds million a year.


CONCLUSIONS
As there is no evidence of any improvement in outcomes overall for the extra cost, the HEMS has not been found to be a cost-effective service.
Brazier
J
J
Medical Care Research Unit, University of Sheffield, UK.
Nicholl
J
J
Snooks
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D017732:Air Ambulances / Q000191:economics* / Q000592:standards; D002648:Child; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D006233:Persons with Disabilities; D006302:Health Services Research / Q000191:economics; D006305:Health Status Indicators; D006801:Humans; D008131:London; D008875:Middle Aged; D009017:Morbidity; D017063:Outcome Assessment, Health Care / Q000191:economics / Q000379:methods*