Consultation Processes With Helicopter Emergency Medical Service Physicians in Finnish Prehospital Emergency Care: The Paramedics’ Perspective

Nordquist, Hilla; Pappinen, Jukka; Torkki, Paulus; Nurmi, Jouni

doi:10.1016/j.amj.2023.07.013

Cited by 2 publications

(1 citation statement)

References 28 publications

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“…It’s also worth considering the broader role of HEMS in implementing the best possible care within the current operational framework. As HEMS crews tend to have a wide range of competencies and experience [ 49 ], efforts in consultations [ 50 ], training activities [ 51 , 52 ], and standardizing the care provided across different regions [ 53 ] could be future development areas that might impact the comprehensive care pathways for stroke patients.…”

Section: Discussionmentioning

confidence: 99%

A scenario based approach to optimizing cost-effectiveness of physician-staffed Helicopter Emergency Medical Services compared to ground-based Emergency Medical Services in Finland

Ackermann,

Pappinen,

Nurmi

et al. 2024

Scand J Trauma Resusc Emerg Med

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Objectives Since Helicopter Emergency Medical Services (HEMS) is an expensive resource in terms of unit price compared to ground-based Emergency Medical Service (EMS), it is important to further investigate which methods would allow for the optimization of these services. The aim of this study was to evaluate the cost-effectiveness of physician-staffed HEMS compared to ground-based EMS in developed scenarios with improvements in triage, aviation performance, and the inclusion of ischemic stroke patients. Methods Incremental cost-effectiveness ratio (ICER) was assessed by comparing health outcomes and costs of HEMS versus ground-based EMS across six different scenarios. Estimated 30-day mortality and quality-adjusted life years (QALYs) were used to measure health benefits. Quality-of-Life (QoL) was assessed with EuroQoL instrument, and a one-way sensitivity analysis was carried out across different patient groups. Survival estimates were evaluated from the national FinnHEMS database, with cost analysis based on the most recent financial reports. Results The best outcome was achieved in Scenario 3.1 which included a reduction in over-alerts, aviation performance enhancement, and assessment of ischemic stroke patients. This scenario yielded 1077.07–1436.09 additional QALYs with an ICER of 33,703-44,937 €/QALY. This represented a 27.72% increase in the additional QALYs and a 21.05% reduction in the ICER compared to the current practice. Conclusions The cost-effectiveness of HEMS can be highly improved by adding stroke patients into the dispatch criteria, as the overall costs are fixed, and the cost-effectiveness is determined based on the utilization rate of capacity.

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Section: Discussionmentioning

confidence: 99%

A scenario based approach to optimizing cost-effectiveness of physician-staffed Helicopter Emergency Medical Services compared to ground-based Emergency Medical Services in Finland

Ackermann,

Pappinen,

Nurmi

et al. 2024

Scand J Trauma Resusc Emerg Med

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Correlation between the accuracy of the emergency response centre’s urgency assessment and emergency medical services non-conveyance: a retrospective register-based study in Finland

Salminen,

Kaartinen,

Palonen

et al. 2024

BMC Emerg Med

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Background In modern emergency medical services (EMS), ambulances increasingly focus on examining and treating the patient at the scene. This has led to increased levels of non-conveyance. In Finland, for instance, approximately 40% of EMS dispatches end up in non-conveyance. As EMS systems evolve, the proportion of non-conveyance could serve as a cost-effective measure to assess the quality of the dispatch criteria, if a link to the performance of urgency assessment would be established. The purpose of this study was to investigate whether the proportion of non-conveyance is associated with the test performance levels of the urgency assessment. This investigation was done separately within each dispatch category. Methods A retrospective evaluation of the data was conducted on all EMS dispatches in the Pirkanmaa Hospital District from 1 August 2021 through 31 August 2021. There were a total of 7,245 EMS dispatches during the study period of which 829 were excluded. This study was conducted by comparing the existing test performance levels (sensitivity, specificity and under- or overestimation) of the emergency response centre’s urgency assessment with the non-conveyance rate (%) of each dispatch category. The relationships between the variables were measured using Spearman’s rank correlation coefficient. Results The proportion of over-triage was the only urgency assessment’s test performance variable that had a statistically significant correlation with the proportion of non-conveyance (r = 0.568; p = 0.003). Other test performance variables of the urgency assessment had no or little correlation to the proportion of non-conveyance. Of the 6,416 EMS dispatches in the study period, 42% (2,672) resulted in non-conveyance of the patient. In nine dispatch categories, at least half (51–69%) of the dispatches ended in non-conveyance. Conclusions Based on this study, it seems that the percentage of non-conveyance in the dispatch category could be used, with certain limitations, to assess the proportion of over-triage in the dispatch category. The method is particularly applicable in scenarios where the dispatch criteria have undergone modifications and there is a need to monitor the effect of the changes on the level of over-triage.

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Consultation Processes With Helicopter Emergency Medical Service Physicians in Finnish Prehospital Emergency Care: The Paramedics’ Perspective

Cited by 2 publications

References 28 publications

A scenario based approach to optimizing cost-effectiveness of physician-staffed Helicopter Emergency Medical Services compared to ground-based Emergency Medical Services in Finland

A scenario based approach to optimizing cost-effectiveness of physician-staffed Helicopter Emergency Medical Services compared to ground-based Emergency Medical Services in Finland

Correlation between the accuracy of the emergency response centre’s urgency assessment and emergency medical services non-conveyance: a retrospective register-based study in Finland

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