Utopia for Norwegian helicopter emergency medical services: Estimating the number of bases needed to radically bring down response times, and lives needed to be saved for cost effectiveness.

Autor: Jagtenberg CJ; Department of Operations Analytics, School of Business and Economics, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands., Uleberg O; Department of Emergency Medicine and Pre-hospital Services, St. Olav`s University Hospital, Trondheim, Norway.; Division of Emergencies and Critical Care, Department of Research and Development, Oslo University Hospital, Oslo, Norway., Waaler Bjørnelv GM; Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.; Department of Health Management and Health Economics, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway., Røislien J; Department of Research, Norwegian Air Ambulance Foundation, Oslo, Norway.; Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2023 Mar 30; Vol. 18 (3), pp. e0281706. Date of Electronic Publication: 2023 Mar 30 (Print Publication: 2023).
DOI: 10.1371/journal.pone.0281706
Abstrakt: Objectives: Helicopter Emergency Medical Services (HEMS) throughout Europe are generally on scene within 10-15 minutes. In Norway, however, with its 13 HEMS bases, only 75% of the population can currently be reached within half an hour. We estimate the number of HEMS bases needed to reach the full Norwegian population within 10-15 minutes, and discuss implications regarding cost effectiveness.
Methods: Using geographic location and population characteristics from Norway's 428 municipalities as input to the Maximal Covering Location Problem-a mathematical location optimization model-we estimate the number of HEMS bases required along with accompanying personnel and healthcare costs. We estimate the minimum number of lives that would have to be saved to achieve a net social benefit of zero.
Results: To reach 99% or 100% of the Norwegian population by HEMS within 15 minutes 78 or 104 bases are needed, respectively. The incremental need for personnel going from 20 to 15 minutes for 99/100% of the population is 602/728, with an accompanying incremental cost of 228/276 million EURO per year. A yearly total of 280/339 additional lives would have to be saved to obtain a net social benefit of zero. Then, the HEMS-system as a whole would be cost effective although the least efficient bases still would not be.
Conclusions: Reducing Norwegian HEMS response times to 10-15 minutes requires a drastic increase in the number of HEMS bases needed. Choice of ethical philosophy (utilitarianism or egalitarianism) determines when the expansion might be considered cost effective.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Jagtenberg et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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