The cost and effectiveness of the London Helicopter Emergency Medical Service

J Health Serv Res Policy. 1996 Oct;1(4):232-7. doi: 10.1177/135581969600100409.


Objectives: To assess the incremental consequences of the London Helicopter Emergency Medical Service (HEMS) for the outcomes of survivors in terms of disability and health status, and cost.

Methods: Prospective comparison of outcomes in cohorts of seriously injured patients attended either by the HEMS or by paramedically crewed land ambulances. In survivors, disability was assessed using an 11-point disability scale, and general health status was measured by the six dimensions of the 100-point Nottingham Health Profile (NHP) assessed 6 months after the injury. Costs were estimated for the HEMS and associated facilities at the Royal London Hospital, and the extra admissions attributable to the HEMS.

Results: There was no evidence of reduced disability in HEMS survivors (estimate: +0.8 disability grades worse; 95% CI: 0, 1.6), and no evidence of improvement in the six NHP dimensions scores or in the mean number of problems with seven aspects of daily living (estimated difference: +0.5; 95% CI: -0.2, 1.2). The incremental costs of HEMS were estimated to be 2.0 Pounds million a year.

Conclusion: As there is no evidence of any improvement in outcomes overall for the extra cost, the HEMS has not been found to be a cost-effective service.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Air Ambulances / economics*
  • Air Ambulances / standards
  • Child
  • Cohort Studies
  • Cost-Benefit Analysis*
  • Disabled Persons
  • Health Services Research / economics
  • Health Status Indicators
  • Humans
  • London
  • Middle Aged
  • Morbidity
  • Outcome Assessment, Health Care / economics
  • Outcome Assessment, Health Care / methods*