[Is the use of helicopters with a XXXX team in severely injured accident victims in The Netherlands cost effective? A modelling approach].

@entity1 @entity130
OBJECTIVE: The assessment of the cost-effectiveness of helicopter medical crews for @entity1 with major @entity130 in the Dutch situation. DESIGN: A modelling approach, combining available information with plausible assumptions. SETTING: Institute for Medical Technology Assessment, Rotterdam. METHODS: First, a baseline scenario was developed, implementing information that was available in the literature and a few assumptions. The sensitivity of the cost-effectiveness for the various assumptions was evaluated in alternative scenarios. END-POINTS. The relation between the costs per life year gained and the expected increase in the number of @entity1 surviving an accident is established for the separate scenarios. RESULTS: In the baseline scenario the number of victims with a @entity130 score < or = 12 is estimated at 4500 per year, it is assumed that victims who die at the scene of the accident are unsalvageable and that hospital treatment costs Dfl. 27,000.--per @entity1 . As a result costs per life year saved are only under Dfl. 50,000.--when more than 29 @entity1 per year (9.23% gain in survival) are additionally saved. Sensitivity analysis shows that the cost-effectiveness depends highly on the expected gain in survival and on the estimate of the costs of hospital treatment. Both variables are surrounded with a lot of uncertainty. CONCLUSIONS: Relying on the information that is available at this moment, no definite conclusions can be drawn on the cost-effectiveness of this facility, because too many essential data are missing. Empirical research is necessary.
