Helicopters as part of a regional EMS system--a cost-effectiveness analysis for three EMS regions in Germany

With increasing health care costs the use of rescue helicopters is being questioned on the grounds of expense. No data exist on the cost-effectiveness of the use of rescue helicopters as part of a regional EMS. The end-point of this study was to analyse the cost-effectiveness of a 15 min response time (state regulation) of advanced life support (ALS) equipment provided by helicopter (1,575,000 DM annual costs) versus a ground-based ambulance (1,004,000 DM annual costs) in three EMS systems (50 km radius) with differing demographic and geographic features in Germany. The effect of varying the ratio of helicopters to ground-based vehicles (ALSC) has also been considered using two additional models. In model 1 each region was allocated one additional helicopter and had six ALS cars removed (daytime only). This improved the response times and saved nearly 1,500,000 DM per year. In model 2 each region had its existing helicopter withdrawn and replaced with six ALS cars. This made response times longer and increased expenditure. In conclusion, the additional use of rescue helicopters in EMS regions (50 km radius) remains cost-effective up to an ALSC:helicopter cost ratio of 1:6.