Szabó Balázs Ádám, Zádori Iván
University of Pécs Medical School (Doctoral School of Clinical Medicine), Hungary.
Heliyon. 2023 Mar 6;9(3):e14336. doi: 10.1016/j.heliyon.2023.e14336. eCollection 2023 Mar.
Helicopter emergency medical services (HEMS) have been integral to healthcare systems in developed countries and are becoming more relevant in developing countries. There is extremely scarce information available regarding the typical cost structure and dynamics of HEMS operation; thus, the limitation of knowledge may limit the shapers of national healthcare policy and potential private operators in starting such a service. This study aims to present the cost dynamics of HEMS operation.
A systematic literature review was performed on open-source studies to obtain appropriate data. International benchmarks were found; nevertheless, as Hungarian data did not emerge, a recent investment into HEMS service was analyzed based on publicly available data from the Hungarian Air Ambulance and affiliated companies. The resulting cost base was allocated per flight hour, and a scenario was established with Western European (German) wages and salaries to challenge the aforementioned international examples.
The average cost of operation is calculated at EUR 2488 per hour or EUR 41.5 per airborne minute based on average mission duration. This result is quite below the German example of ca. EUR 55.4 per airborne minute and even less than the US and Australian examples, but once the costing model was recalculated with German salaries, the result was extremely similar to the literature review. Nevertheless, comparable international figures need further research, as ownership structure, cost allocation method, and accounting regimes may dramatically impact the cost per airborne minute.
The cost of EUR 2488 per flight hour is a good indicator for an hourly rate of operations; however, when deciding on establishing such a service, the model needs to be adjusted for comparable salaries and foreign exchange rates. Nevertheless, if the number of flight hours can be well estimated, the yearly funding needs can be accurately determined using it.
直升机紧急医疗服务（HEMS）在发达国家的医疗体系中不可或缺，且在发展中国家的重要性也日益凸显。关于HEMS运营的典型成本结构和动态变化，现有信息极为匮乏；因此，知识的局限性可能会限制国家医疗政策制定者以及潜在的私人运营商开展此类服务。本研究旨在呈现HEMS运营的成本动态变化。
对开源研究进行系统的文献综述以获取合适的数据。虽找到了国际基准；然而，由于未出现匈牙利的数据，基于匈牙利空中救护及附属公司公开可得的数据，对近期一项HEMS服务投资进行了分析。将得出的成本基数按飞行小时进行分摊，并设定了一个采用西欧（德国）工资和薪水的情景，以对照上述国际案例。
根据平均任务时长计算，运营平均成本为每小时2488欧元或每空中飞行分钟41.5欧元。这一结果远低于德国每空中飞行分钟约55.4欧元的案例，甚至低于美国和澳大利亚的案例，但一旦用德国薪资重新计算成本模型，结果与文献综述极为相似。不过，由于所有权结构、成本分摊方法和会计制度可能会极大地影响每空中飞行分钟的成本，可比较的国际数据仍需进一步研究。
每飞行小时2488欧元的成本是运营小时费率的一个良好指标；然而，在决定开展此类服务时，该模型需根据可比薪资和汇率进行调整。不过，如果能准确估算飞行小时数，利用它就能准确确定年度资金需求。
