Interfacility Transport of Emergency Department Patients by Helicopter Air Ambulance: A Simulation Study of Utilization.

OBJECTIVE

Interfacility transports by helicopter air ambulance (IFT-HAAs) are requested for critically ill and injured patients. Requests for patient transport may originate from several settings within the referring facility: the emergency department (ED), procedural areas (such as a cardiac catheterization laboratory), or inpatient units such as an intensive care unit. Existing literature has not clarified the contributions of the ED compared with other facility settings.

METHODS

In this retrospective modeling study, we used data from the Federal Aviation Administration, National Hospital Ambulatory Medical Care Survey, and flight request data from a multicenter convenience sample of 3 nonprofit, hospital-based helicopter air ambulance operators between 2016 and 2018. We used a deterministic model to estimate the proportions of all IFT-HAAs originating from the ED and the proportion of ED patients intended for disposition by IFT-HAA.

RESULTS

Compared with all other hospital care settings, the ED is the source of more than 75% of all IFT-HAAs in this sample of 3 flight programs. Nationally, IFT-HAA is estimated as the intended disposition for approximately 0.2% of all ED patients; this result seems stable over the 3 years included in this study.

CONCLUSION

The intended disposition for 0.2% of ED visits is estimated to be IFT-HAA. Given that ED-dispositioned patients represent more than 75% of all IFT-HAAs in this sample of 3 flight programs, efforts to promote appropriate utilization of IFT-HAA should prioritize engagement with emergency physicians.