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Monday

Air Medical. At What Cost?

I have the deepest respect for my colleagues who work in the air medical arena. I also have little doubt that air medical transport with helicopter and fixed-wing aircraft have saved untold numbers of lives throughout the Country. In general I support air medical, albeit with some reservation on the use of helicopters.

I've written about the potentials of landing a helicopter at your emergency scene or on the roof of a hospital (a totally bad idea as far as I'm concerned) and you can read my comments in Mitigation Journal http://mitigationjournal.blogspot.com/2008/05/helicopters-and-hospitals.html one persons opinion may be that helicopters and operating with lights and siren are the two biggest contributors to EMS LODD...maybe they should be avoided...and at all costs, keep your helicopters off of and away from your hospitals!


Todays posting is going to look at another, less deadly impact of air medical transport...cost. MSNBC is running an article with focus on the cost of emergency helicopter transport and the health care system. According to MSNBC, the cost of this service can be anywhere from $12,000 to $25,000 and that cost may not be covered by insurance. Sure, we can't put a price on a life...and I would certainly pay that amount and more for any of my family...gladly. I think what is at issue here is the fact that these flights are not always deemed appropriate. Even in the setting of trauma other alternatives to air medical transport my have provided the same outcome at a fraction of the cost.

Another issue is choice. Victims of trauma who are in serious condition may not have the capacity to provide informed consent for air transport. The public is trusting the emergency responders to make the best choice for their care. Transport mode should be a decision, like any other, made carefully and with the patients best interest in mind. In these cases the "customer" has little choice. And on that note, please remember we treat patients...not customers. Read my comments on the word "customer".

So let this one sink in a while. When is air medical helicopter really needed? How can this service be put to best use...when should it be avoided? Patient condition, injury severity, distance to definitive care, and weather conditions are just some of the points to ponder. Now we have to add in cost...or better stated; cost effectiveness. Will air medical transport make a difference in relation to the non-covered cost in relation to ground transport alternatives.  More to follow on this...and I welcome your opinion.

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