Accessibility and distribution of the Norwegian National Air Emergency Service: 1988-1998.
OBJECTIVE
To evaluate the accessibility and distribution of the Norwegian National Air Emergency Service in the 10-year period from 1988 to 1998.


METHODS
The primary material was annual standardized activity data that included all helicopter missions. A multivariate model of determinants for use of the helicopter service was computed by linear regression. Accessibility was measured as the percentage of the population reached in different flying times, and we evaluated the service using a simulation of alternative locations for the helicopter bases.


RESULTS
The helicopter service (HEMS) has short access times, with a mean reaction time of 8 minutes and a mean response time of 26 minutes for acute missions. Nearly all patients (98%) are reached within 1 hour. A simulation that tested alternative locations of the helicopter bases compared with current locations showed no increase in accessibility. The use of the service shows large regional differences. Multivariate analyses showed that the distances of the patients from the nearest helicopter base and the nearest hospital are significant determinants for the use of HEMS.


CONCLUSIONS
Establishment of a national service has given the Norwegian population better access to highly qualified prehospital emergency services. Furthermore, the HEMS has a compensating effect in adjusting for differences in traveling distances to a hospital. Safety, cost-containment, and gatekeeper functions remain challenges.
Heggestad
Torhild
T
SINTEF Unimed Health Services Research, Trondheim, Norway.
Børsheim
Knut Yngve
KY
D017732:Air Ambulances / Q000706:statistics & numerical data / Q000600:supply & distribution*; D004632:Emergency Medical Services / Q000706:statistics & numerical data / Q000600:supply & distribution*; D005843:Geography; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006801:Humans; D015999:Multivariate Analysis; D009313:National Health Programs; D009664:Norway; D010818:Practice Patterns, Physicians'; D012044:Regression Analysis; D017751:Safety Management; D013997:Time Factors; D014187:Transportation of Patients