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Statewide helicopter utilization review: the Massachusetts experience.
K A Williams1, R Aghababian, M Shaughnessy
1New England Life Flight, University of Massachusetts Medical Center, Worchester.
The Journal of Air Medical Transport
|August 7, 1990
Summary
Utilization Review (UR) of air medical services in Massachusetts improved patient care and provider referrals. This review process, analyzing over 2,500 flights, identified patient groups and aided reimbursement, benefiting both patients and services.
Area of Science:
- Medical transport services
- Healthcare management
Background:
- Air medical services were established in Massachusetts in 1982.
- Utilization Review (UR) for these services commenced in 1985.
Purpose of the Study:
- To evaluate the impact and effectiveness of a Utilization Review program for air medical services.
- To assess the benefits of external review for helicopter transport.
Main Methods:
- External review of all air medical flights using established screening criteria.
- Analysis of over 2,500 reviewed flights between 1982 and 1989.
Main Results:
- Less than 2% of reviewed flights were deemed inappropriate.
- Improved referrals from prehospital and hospital providers.
- Identification of specific patient groups (e.g., transplant, regional bed shortages) and enhanced third-party reimbursement.
Conclusions:
- A coordinated Utilization Review process benefits both patients and air medical services.
- The review process has not yet identified unmet needs or inappropriate ground ambulance utilization.
- Further research is needed to compare outcomes across different transport modes.