Cost dynamics of helicopter emergency services: A Hungarian example

OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.