Medical helicopter viability studies

  • Medical helicopter actually benefit only a small number of patients.    Studies indicated that many EMS providers summon medical helicopters when the patient’s condition may not warrant their use.
  • Only 22.8% of study patients possibly benefited from helicopter transport. They further found that 33.5% of patients transported by helicopter were discharged from the emergency department and not admitted to the hospital; 85% of patients were considered to have minor injuries. Of the patients transported by helicopter in their study, 33% were discharged home from the emergency department and not admitted to the hospital.14
  • Injured children were considered over-triaged.15 A Boston study of 1,523 patients transported by helicopter found that 24% of patients transported from an accident scene were deemed inappropriate.16
  • When the University of Texas Medical Branch at Galveston discontinued its hospital-based air medical helicopter, they found that there was no decrease in transport time or increase in mortality for trauma patients at their facility.21
  • In a North Carolina study, researchers found that only a very small subset of patients transported by helicopter appeared to have any chance of improved survival based on their helicopter transport.23
  • In an eight-year Pennsylvania study of 3,048 penetrating-trauma victims, researchers found that patients transported by helicopter had longer transport times and no significant difference in mortality compared with
  • those transported by ground.26 Likewise, transport of patients with severe head injuries and burns do not appear to benefit from helicopter transport.27,28
  • Furthermore, these studies indicate that many EMS providers summon medical helicopters when the patient’s condition may not warrant their use.
  • Inter-facility transfers between hospitals. Could for the most part just as well been transferred by ambulance.
  • A factor often overlooked is helicopter safety.
  • Significant amount of financial resources are going into a transport modality that actually benefits few patients. These large sums of money would buy many AEDs and ground ambulances that would stand to benefit more of our citizenry. With a dwindling healthcare dollar, we will soon have to make some tough decisions.
  • There certainly is a role for helicopters in EMS, but we have them in the wrong places. The majority of the fleet is parked atop hospitals in urban centers where ground transport takes only minutes. They need to be positioned where they will benefit the people who need them the most–those who live in rural settings
  • Thus, there should be a strategically placed network of helicopters that serves rural hospitals and providers. However, as long as hospitals operate helicopters as “flying billboards,” this will probably never happen.

 

 

 

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Emergency air ambulance regulation?

As helicopter medevac has evolved over the years, it has grown to over 1000 helicopters in the United States and are quite competitive.  At the same time they have become controversial in the consumer arena as patients have later received high medical bills they never expected.   It is ironic that the vehicle that has gone out to save a life in a critical life threatening situation,  has many times been in an accident.    A conversation needs to take place about how air ambulances are regulated and how to prevent accidents.

See Pdf:  UP-in-the-air- Inadequate-Regulation-for-emergency-air ambulance

Inadequate regulation of air ambulances

If you are someone who lives in a rural area and have an accident that is life threatening, para-medics are called to assess the situation. If indeed, your injury is a life and death matter, a medical helicopter may be called to transport you to hospital. In this situation, you are at a disadvantage as a patient. You and family are frightened and feel you must rely on the judgment of the medic. In some instances, a helicopter may not be the right decision and may leave the family straddled with an incredible medical bill for transport. One’s insurance may or may not cover helicopter transport. In some instances, a patient may be billed up to $40,000 with no real means to pay for service.   The medical helicopter industry rapidly grew with for-profit carriers. With this came patient consumer complaints and pleas for help as families were dogged for payment they could not meet. Unfortunately federal law has not helped to provide consumer protection. There is inadequate regulation of air ambulances that needs to be addressed at the state level.   The federal Airline Deregulation Act of 1978 preempts states from regulating rates, routes or services of any air carrier. The Department of Transportation concludes that air ambulances are “air carriers.”  Therefore, states are preempted from regulating their services. The big question is how to correct this gap and protect consumers who unsuspected are slammed with an exorbitant bill?

 

Consumer beware

Anyone who has been picked up by a medical helicopter and transported to a hospital after an accident  can come into a big surprise when they get the bill.  Today there is a culture of high competition in a market place that is over gutted with helicopters.  The victim does not call for helicopter service; that decision is made by a first responder who assesses the patient and makes the call for transport.  In some instances,  a helicopter may not have been necessary in the first place.  An ambulance may have been able to transport in a more timely fashion or the victim’s injuries really did not qualify for trauma intervention.  An injury can be a highly emotional situation fed by fear of loss of life.  Typically,  insurance does not provide for helicopter transport and a victim really has no real understanding of what they are in for.  Unfortunately, federal law has often preempted state regulations that might otherwise protect consumers.  Clearly there needs to be some kind of protection in place so that the patient does not end up with extreme medical bills and no way to pay.  Lawsuits abound in the industry.  At this point in time, higher Medicare reimbursement rates along with minimal regulation has transformed an essential life-saving service into one with little oversight, multiple accidents claiming lives and predatory billing practices.

Copyright 2017

 

 

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Air ambulance system out of control

Today there are over 1000 air ambulances in the United States. Competition is fierce as for profit companies are driving out nonprofits. The alarming thing in this industry is how predatory the air ambulance industry has become as they seek to cash in on the injured. In a number of instances, the patient’s location is within a reasonable distance to be transferred by ambulance. Also, patient injuries are not extensive enough to warrant calling for a helicopter.   The patient may arrive at the hospital and then be discharged from the emergency room. A first responder has made a poor judgment in calling for an air ambulance. Tragically, the patient had no say in what took place. The family had no idea that insurance will  not pay for transport and are stuck with a $30,000 bill for the ride. Unfortunately, deregulation of the airline industry left states unable to regulate air ambulance services or protect consumers from predatory practices.

Added to all of this is the dilemma of helicopter safety. Pilots may be under intense pressure to transport and this might affect his judgment. At this point in time, there has been an alarming rate of helicopter accidents that claim the lives of staff and patient.   Clearly, this is an industry with multiple system problems that jeopardize patients and families who are then left with astounding medical bills that are unwarranted.

The big question is: what can be done to change the system and protect the unsuspecting injured and their family?

Copyright 2017

#helicopter safety #helicopter shopping

Given the numerous helicopter accidents one has to wonder how helicopter medevac can really be profitable. Hospitals have, indeed, taken on a chopper with the hope of increasing revenue by extending their reach. A lot of pressures exerted on pilots to fly even when it may not be safe to do so. Staff who eagerly want to be of service, may have clouded judgment. Administrators may have undue pressures on the pilot to perform. Still, it is the pilot who flies and ultimately needs to make the call to go or not go. Other dynamics play into the situation as EMS on the ground shop around and pit one service against another. Competition exists in all industries. In helicopter medevac it is a dangerous game with a great deal of potential for disaster to claim the lives of not only the crew, but the patient they were assumedly trying to rescue. The record speaks for itself. How many lives must be lost before the EMS system comes to its senses and openly deal with the reality of the problem.

Copyright 2017  all rights reserved.

Are #medical #helicopters cost effective

Studies have been done to evaluate whether or not helicopters are cost effective and are really out there saving lives.  In effect,  money  hospitals lose in the helicopter business results in higher costs for other services that will then be passed on to insurance companies or patients.   In fact, there are studies that show patients transported were inappropriate because they were not true trauma cases.   Many were discharged from the emergency department and not hospitalized.   Studies in other countries are revealing similar scenarios.

Given all the recent social political events hitting on us daily, some may be pacing and wonder what’s next.  Healthcare and its cost is definitely on the radar.  Trump has flipped from one position to the opposite on a variety of things.  Social Security and Medicare could potentially be cut by Congress.  When Medicare decided it would pay for helicopter medevac, many hospitals jumped on the bandwagon to fly.  If cuts are made to Medicare, how will helicopter medevac fair?  Already the industry must be struggling with issues of survival because of high insurance premiums, lawsuits and accidents.

Think about it; are helicopters really cost effective?

 

 

Obesity and helicopter medevac

The National Center for Health Statistics reports obesity in America has reached alarming rates. It is one of the biggest drivers of healthcare costs that are estimated to range from $147 billion to nearly $210 billion per year. 68.5% of adults are overweight and 34.9% are obese.  Obesity among children and adolescents has escalated.   31.8% are overweight and 16.9% are obese. This is alarming and preventable. Certainly obesity has a negative effect as it increases diabetes and other health conditions.

In a critical care situation where a helicopter is called for transport, it is estimated 5,000 US patients are denied helicopter transport each year because they are too heavy or large to fit in an aircraft. This has created a dilemma for air transport providers. In an NBC report, Craig Yale, vice president of corporate development for Air Methods said, “It’s an issue for sure. We can get to a scene and find the patient is too heavy to be able to go.”    If a patient is too large or heavy to fit in the helicopter, they may not be able to receive the urgent care they need in a fast enough manner. In some cases patients simply cannot fit through the doors. In some instances, an overweight person may be able to fit into the aircraft, but their weight can sometimes prevent a helicopter from lifting off the ground.  This can pose a dangerous risk to all on board. A helicopter crashed in New York’s East River in October 2011 because it was over capacity by 50 pounds.

Americans seem to be sleep walking as they go about getting larger and larger compromising their health and setting poor examples for their children.   Helicopter transport services face having to deny service or invest in larger helicopters.   Obesity is something we need to address in schools and various healthcare facilities by focusing on the problem and teaching sound nutrition.   It can be difficult because when you attempt to mention the problem, a person may feel insulted and defensive. Still, programs need to be set in place to prevent this condition. It’s in everyone’s best interest.

The National Center for Health Statistics reports obesity in America has reached alarming rates. It is one of the biggest drivers of healthcare costs that are estimated to range from $147 billion to nearly $210 billion per year. 68.5% of adults are overweight and 34.9% are obese.  Obesity among children and adolescents has escalated.   31.8% are overweight and 16.9% are obese. This is alarming and preventable. Certainly obesity has a negative effect as it increases diabetes and other health conditions.

In a critical care situation where a helicopter is called for transport, it is estimated 5,000 US patients are denied helicopter transport each year because they are too heavy or large to fit in an aircraft. This has created a dilemma for air transport providers. In an NBC report, Craig Yale, vice president of corporate development for Air Methods said, “It’s an issue for sure. We can get to a scene and find the patient is too heavy to be able to go.”    If a patient is too large or heavy to fit in the helicopter, they may not be able to receive the urgent care they need in a fast enough manner. In some cases patients simply cannot fit through the doors. In some instances, an overweight person may be able to fit into the aircraft, but their weight can sometimes prevent a helicopter from lifting off the ground.  This can pose a dangerous risk to all on board. A helicopter crashed in New York’s East River in October 2011 because it was over capacity by 50 pounds.

Americans seem to be sleep walking as they go about getting larger and larger compromising their health and setting poor examples for their children.   Helicopter transport services face having to deny service or invest in larger helicopters.   Obesity is something we need to address in schools and various healthcare facilities by focusing on the problem and teaching sound nutrition.   It can be difficult because when you attempt to mention the problem, a person may feel insulted and defensive. Still, programs need to be set in place to prevent this condition. It’s in everyone’s best interest.

The National Center for Health Statistics reports obesity in America has reached alarming rates. It is one of the biggest drivers of healthcare costs that are estimated to range from $147 billion to nearly $210 billion per year. 68.5% of adults are overweight and 34.9% are obese.  Obesity among children and adolescents has escalated.   31.8% are overweight and 16.9% are obese. This is alarming and preventable. Certainly obesity has a negative effect as it increases diabetes and other health conditions.

In a critical care situation where a helicopter is called for transport, it is estimated 5,000 US patients are denied helicopter transport each year because they are too heavy or large to fit in an aircraft. This has created a dilemma for air transport providers. In an NBC report, Craig Yale, vice president of corporate development for Air Methods said, “It’s an issue for sure. We can get to a scene and find the patient is too heavy to be able to go.”    If a patient is too large or heavy to fit in the helicopter, they may not be able to receive the urgent care they need in a fast enough manner. In some cases patients simply cannot fit through the doors. In some instances, an overweight person may be able to fit into the aircraft, but their weight can sometimes prevent a helicopter from lifting off the ground.  This can pose a dangerous risk to all on board. A helicopter crashed in New York’s East River in October 2011 because it was over capacity by 50 pounds.

Americans seem to be sleep walking as they go about getting larger and larger compromising their health and setting poor examples for their children.   Helicopter transport services face having to deny service or invest in larger helicopters.   Obesity is something we need to address in schools and various healthcare facilities by focusing on the problem and teaching sound nutrition.   It can be difficult because when you attempt to mention the problem, a person may feel insulted and defensive. Still, programs need to be set in place to prevent this condition. It’s in everyone’s best interest.

 

#Assassination Generation

I have been reading an alarming book that definitely needs to be widely read:  Assassination Generation by Lt. Col. Dave Grossman.  This book is about how children are being essentially trained to be murders by indulging in violent video games.  As a clinical psychologist and a concerned citizen, I have spoken to parents about how learned behaviors in the young go into the subconscious mind and later manifest.  Assassination Generation is a well-researched book with a lot of examples of young people who have gone out and carried out mass killings across this nation.   Every day, we hear of a young person obsessed with killing manages to go out and in irrational ways claiming the lives of innocent people.  America needs to wake up!  The video industry is making massive amounts of money targeting our young in addictive destructive behavior.  Read this book and share it, talk about this problem and help save the children.

Tough decisions 2017

As 2017 begins,  civilian helicopter medevac seems to still be an industry with ongoing  accidents injuring or claiming lives  still on the radar.  At the same time, there’s news of a new helicopter service for children in Atlanta,  called an  “flying  ICU”  the first of its kind that can transport critically injured children and their parents.   So there’s the potential for good news or ongoing bad news.  This seems to be an industry that must inevitably have to make hard line decisions.  Given the cost of a helicopter and staff to provide critical care intervention, one must consider how effective helicopter medevac service really is.  There are perceptions that this is a glutted helicopter market serving few patients.  Health care costs have not stopped escalating.  There was a study in the Silicon Valley area of California that reviewed 947 trauma patients transported to their trauma center.  Their findings were:  only 22.8% of those patients possibly benefited from transport.  In addition, they found that 33.5% of those patients were discharged from the ER and not admitted to the hospital.  So what’s the problem?   Are field personnel in need of greater training to be able to make more effective assessments?  Another good question is:  Did those transported between facilities by air have better outcomes than those transported by ground?    Without a doubt,  more research is needed so that the industry can make sound decisions that will improve life for those injured, and avoid tragic accidents claiming lives.  Continued high cost transport certainly drives escalating health care costs.  What can/ should the helicopter industry do?  What might constitute best business practice?