Röper Johann, Krohn Markus, Fleßa Steffen, Thies Karl-Christian
Chair of General Business Administration and Health Care Management, Faculty of Law and Economics, University of Greifswald, Friedrich-Loeffler-Straße 70, 17489, Greifswald, Germany.
Department of Anesthesiology and Intensive Care Medicine, University Medical Center Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany.
Health Econ Rev. 2020 Oct 8;10(1):34. doi: 10.1186/s13561-020-00287-8.
Helicopter emergency services (HEMS) are of increasing relevance for emergency medical services (EMS) of developed countries. Despite the known cost intensity of HEMS, there is only very limited knowledge of its cost dynamics and structures. This averts an efficient resource allocation of scarce EMS resources in an environment that is characterized by socio-political, medical and economic challenges. The objective of this study is the exemplary modeling of HEMS cost structures.
We defined three scenarios with each five variations to illustrate different models of HEMS provision. Into these, we included varying availability times, technical features for off-shore or alpine rescue and differing numbers of operations. Cost data is based on a broad literature review and primary data from a German HEMS organization resulting in a cost function. We calculated average costs per primary missions and total costs, whilst differentiating between fixed, jump-fixed, variable and maintenance costs for every scenario variation. The costs were further used to evaluate the profitability of operations by executing a break-even analysis.
Average costs per HEMS operation decrease with increasing number of operations due to the digression of fixed costs. Depending on special equipment, availability times or other assumptions, total costs differ significantly with the different scenario variations. For the basic scenario (12 h of operations per day), the total costs per year of HEMS are 1,697,546.20 € and the unit costs are 763.41 € per primary mission at 1200 primary and 92 secondary operations. At an engine-runtime based revenue of 70 € per minute, global cost covering is possible after 728 missions (c.p.).
Considering a revenue of 70 € per minute of engine run-time, HEMS can be operated at a profit for companies. However, the necessary remuneration represents a high financial effort for the societal cost bearers of helicopter emergency services. This leads to the question of the cost-benefit ratio of HEMS, which could be approached in further researches by using this model. The valuation of mission costs also opens a new view to the framework of HEMS disposition procedures and criteria. This cost analysis enhances the necessity of better planning of HEMS networks to use available resources efficiently in order to improve social welfare.
直升机紧急医疗服务（HEMS）在发达国家的紧急医疗服务（EMS）中愈发重要。尽管已知HEMS成本高昂，但对其成本动态和结构的了解却非常有限。这阻碍了在一个面临社会政治、医疗和经济挑战的环境中对稀缺的EMS资源进行有效资源分配。本研究的目的是对HEMS成本结构进行示例性建模。
我们定义了三种情景，每种情景有五个变体，以说明不同的HEMS提供模式。其中包括不同的可用时间、海上或高山救援的技术特征以及不同的作业次数。成本数据基于广泛的文献综述和来自德国一个HEMS组织的原始数据，得出了一个成本函数。我们计算了每次主要任务的平均成本和总成本，同时区分了每个情景变体的固定成本、跳跃固定成本、可变成本和维护成本。通过进行盈亏平衡分析，这些成本进一步用于评估运营的盈利能力。
由于固定成本的分摊，每次HEMS运营的平均成本随着运营次数的增加而降低。根据特殊设备、可用时间或其他假设，不同情景变体的总成本差异显著。对于基本情景（每天运营12小时），在1200次主要任务和92次次要任务的情况下，HEMS每年的总成本为1,697,546.20欧元，每次主要任务的单位成本为763.41欧元。在基于发动机运行时间每分钟收入70欧元的情况下，在728次任务后（按可比价格计算）可以实现全球成本覆盖。
考虑到发动机运行时间每分钟70欧元的收入，HEMS对公司来说可以实现盈利运营。然而，所需的报酬对直升机紧急医疗服务的社会成本承担者来说是一项巨大的财政负担。这引发了HEMS成本效益比的问题，在进一步的研究中可以使用该模型来探讨。任务成本的评估也为HEMS部署程序和标准的框架提供了新的视角。这种成本分析增强了更好地规划HEMS网络以有效利用可用资源以提高社会福利的必要性。
