Electronic Thesis/Dissertation



ABSTRACTFACTORS INFLUENCING THE IMPLEMENTATION OF HELICOPTER AMBULANCE SERVICE IN MEDICAL FACILITIESThe need for transporting patients who require emergency care--the critically ill or seriously injured from to motor vehicle crashes--either on-the-scene of the accident or between medical facilities, has resulted to the accelerated growth of Helicopter Emergency Medical Service (HEMS) programs worldwide. Particularly in the United States, the number of medical facilities deploying the HEMS programs has been steadily rising. According to the Association of Air Medical Services (AAMS), the helicopter ambulance programs in the U.S. have doubled during the past ten years.Several studies have debated the sustainability of air ambulance service deployment for the injured victims of motor vehicle accidents. Although some studies do not prove that helicopter transports are ineffective, "it does however, raise serious questions about the appropriateness of the use of helicopter transport" (Cunningham et al. 1997). Helicopter ambulance assistance is considered a high cost service unit: the average disbursement for each helicopter intervention mission ranges between $8,000 and $12,000, which makes it very costly for all the parties involved.The intent of this research study was to determine, list and rank in importance the factors influencing the implementation of helicopter emergency assistance programs and to rank them according to their significance in reference to the two survey instruments developed especially for the purpose of interviewing relevant specialists in the field of civilian helicopter ambulance services. The study was performed in the greater Washington, D.C., and Baltimore area. The first survey was conducted between May and September of 2008. The interviewees were requested to identify and list the factors which they associated with the decision for helicopter ambulance service intervention. Within three months' period, the second survey was performed. The interviewees were instructed to rank the top twelve factors which they cited in the first round of interviews, using a pair-wise comparisons questionnaire. Their responses were analyzed by means of the Bradley-Terry (BT, 1952) psychometric model to scale preferences and gauge the relative importance of the twelve factors. The results of our research study have demonstrated that, among the specialists in the field, there is a noteworthy inclination to choose patient-related aspects, which constituted over two thirds of the total number of factors. For instance, the most highly ranked were the following attributes: access to definitive care, improving quality of services, and providing inter-facility service. Non-patient related factors were ranked as least relevant of all to be considered.

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