title: Willingness to pay for lives saved by Helicopter Emergency Medical Services.
abstract: BACKGROUND
  Currently, policy makers in the Netherlands are discussing the possibility to expand the availability of Helicopter Emergency Medical Services (HEMS) from 12 hours to 24 hours per day. For this, the preferences of the general public towards both the positive effects and negative consequences of HEMS should be taken into account. Therefore, the willingness to pay (WTP) for lives saved by HEMS was calculated.
  
  
  METHODS
  A discrete choice experiment (DCE) was performed in order to explore the preferences of respondents towards (expansion of) HEMS availability. The attributes: costs (for HEMS) per household number of additional lives saved (by HEMS), number of noise disturbances (caused by HEMS) during day time or night time were used. A written questionnaire was presented to 150 individuals by convenience sampling.
  
  
  RESULTS
  One hundred and thirty-six (91%) of the 150 individuals completed the DCE questionnaire. The marginal WTP for one additional life saved (in a month) was euro 3.43 (95% CI; 2.96-3.90) per month per household. Overall, the WTP for expansion to a 24-hour availability of HEMS can therefore be estimated at euro 12.29 ( approximately US$ 17.50) per household per month.
  
  
  CONCLUSIONS
  The WTP derived from this study is by far exceeding the 1-1.5 Million-euro necessary per HEMS per year for the expansion from a daytime HEMS to a 24-h availability in the Netherlands. Respondents are willing to pay for lives saved by HEMS in spite of increases in flights and concurrent noise disturbances. These results may be helpful for the decision-making process, and may provide a positive argument for the expansion of HEMS availability.
authors.affiliation: Department of Surgery-Traumatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. a.ringburg@erasmusmc.nl
authors.forename: Akkie N
authors.initials: AN
authors.lastname: Ringburg
authors.forename: Martina
authors.initials: M
authors.lastname: Buljac
authors.forename: Elly A
authors.initials: EA
authors.lastname: Stolk
authors.forename: Esther M M
authors.initials: EM
authors.lastname: van Lieshout
authors.forename: Ed F
authors.initials: EF
authors.lastname: van Beeck
authors.forename: Peter
authors.initials: P
authors.lastname: Patka
authors.forename: Inger B
authors.initials: IB
authors.lastname: Schipper
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017732:Air Ambulances / Q000191:economics*; D005260:Female; D017048:Health Care Costs; D006291:Health Policy / Q000191:economics*; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011639:Public Opinion; D011795:Surveys and Questionnaires; D055815:Young Adult