Overutilization of Helicopter Emergency Medical Services in Central Gulf Coast Region Results in Unnecessary Expenditure.

Autor: Miles MVP; Department of Surgery, The University of South Alabama School of Medicine, Mobile, Alabama., Beasley JR; Department of Surgery, The University of South Alabama School of Medicine, Mobile, Alabama., Reed HE; Department of Surgery, The University of South Alabama School of Medicine, Mobile, Alabama., Miles DT; University of Mississippi School of Medicine, Jackson, Mississippi., Haiflich A; Department of Surgery, The University of South Alabama School of Medicine, Mobile, Alabama., Beckett AR; Department of Surgery, The University of South Alabama School of Medicine, Mobile, Alabama., Lee YL; Department of Surgery, The University of South Alabama School of Medicine, Mobile, Alabama., Bowden SE; Department of Emergency Medicine, The University of South Alabama School of Medicine, Mobile, Alabama., Panacek EA; Department of Emergency Medicine, The University of South Alabama School of Medicine, Mobile, Alabama., Ding L; Department of Surgery, The University of South Alabama School of Medicine, Mobile, Alabama., Brevard SB; Department of Surgery, The University of South Alabama School of Medicine, Mobile, Alabama., Simmons JD; Department of Surgery, The University of South Alabama School of Medicine, Mobile, Alabama., Butts CC; Department of Surgery, The University of South Alabama School of Medicine, Mobile, Alabama. Electronic address: cbutts@health.southalabama.edu.
Jazyk: angličtina
Zdroj: The Journal of surgical research [J Surg Res] 2022 May; Vol. 273, pp. 211-217. Date of Electronic Publication: 2022 Jan 29.
DOI: 10.1016/j.jss.2021.12.038
Abstrakt: Introduction: When appropriately used, helicopter emergency medical services (HEMSs) allow for timely delivery of severely injured patients to definitive care. Inappropriate utilization of HEMSs results in increased cost to the patient and trauma system. The purpose of this study was to review current HEMS criteria in the central Gulf Coast region and evaluate for potential areas of triage refinement and cost savings. We hypothesized that a significant number of patients received potentially unwarranted HEMS transport.
Methods: A retrospective cohort study of all patients with trauma arriving to a level I trauma center by helicopter over 28 mo was performed; 381 patients with trauma and with HEMS transport from the scene were included. Data were collected from prehospital sources, as well as hospital chart review for each patient. The primary outcome was the rate of unwarranted HEMS transport.
Results: A total of 381 adult patients with trauma transported by the HEMS were analyzed, of which 34% were deemed potentially nonwarranted transports. The significant factors correlating with warranted HEMS transport included age, multiple long bone fractures, penetrating mechanism, and vehicle ejection. Insurance demographics did not correlate to transport modality. Many of these patients were transported from a location within the same county or the county adjacent to the trauma center. When comparing patients transported by ground and HEMSs from the same scene, no time savings were identified. Unwarranted transports at the trauma center represented an estimated health care expenditure of over $3 million.
Conclusions: HEMSs may be overused in the central Gulf Coast region, creating the risk for a substantial resource and financial burden to the trauma system. Further collaboration is needed to establish HEMS triage criteria, that is, more appropriate use of resources.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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