Helicopter vs. ground-based transfer for emergency interhospital transportation: A time and cost-efficiency analysis...

Emergency interhospital transfer can be conducted using either ground-based emergency medical services (GEMS) or helicopter emergency medical services (HEMS). The choice between these modes of transportation relies mostly on urgency and transfer distances, however they are further influenced by road traffic, weather and resource availability. While some studies suggest that HEMS may improve survival rates for severely injured patients, the time efficiency of HEMS versus GEMS across varying distances remains underexplored.

This retrospective clinical cohort study analyzed 1784 emergency interhospital transfers from 11 hospitals to Innsbruck University Hospital in Austria, over a 10-year period (2013-2023), comparing efficiency of GEMS and HEMS across distances from 11 hospitals within a 115 km radius. Outcome assessment included time duration of distinct phases of transfer, including dispatch time, isolated transport duration, overall transfer duration, total resource occupancy time, and cost efficiency.

HEMS was primarily used for longer distances, while GEMS were almost exclusively used for transports <30 km. For hospitals >50 km away, the mean overall transfer duration was 58.1 (± 16.5) minutes for HEMS and 77.1 (± 20.3) minutes for GEMS (p < 0.001). For hospitals within 50 km, the mean overall transfer duration was 46.4 (± 13.9) minutes for HEMS and 44.0 (± 12.9) minutes for GEMS (p = 0.175). Cost analysis revealed that HEMS was significantly more expensive than GEMS, with a cost disparity of up to 17 times the cost per route.

GEMS is more efficient and should be considered for all transfers under 30 km, while HEMS offers a time advantage for distances exceeding 50 km, providing potentially crucial time savings in time-critical cases. For intermediate distances, HEMS may be justified when reducing treatment delays is essential. Decisions regarding transport modality should consider not only the distance but also urgency and the potential clinical benefits of faster treatment. Future studies should examine the clinical outcomes of different transfer modes to better guide transport decisions.