Air transport of trauma patients: An exploration of policy, technology, cost, and outcomes in health care

The health care system in the United States is regarded as the most sophisticated and advanced in the world. However, a growing reluctance to shoulder the expense burden of the current system is emerging. This study seeks to explore the current system, the values and history which underpin it, and through a case-in-point approach, look at ways in which the health system may be effectively changed without great harm.; A conceptual framework is utilized which includes Dye and Zeigler's (1975) description of Elite Theory as well as Wilensky and Lebeaux's concepts of institutionalized versus residual social policy. Both have great applicability to health care which is expounded upon.; A review of the literature is utilized to provide background for the study, explore the history and values underpinning policy, and overview the health care and trauma literature. A broad and non-exhaustive approach to the literature is taken to bring together several areas of exploration which have impact on the topic.; The case-in-point research focus looks at air ambulance services as an example of high-cost, high-tech medicine. A sample patient group is utilized to explore differences in survival, resource use and outcome, based on whether the trauma patient is transported by air or ground.; Logistic regression and multiple regression are used to test for differences between the air and ground-transported groups. The results indicate that air-transported patients have significant improvements in survival, but at much higher cost. No significant differences were found in either resource use or patient outcome based on mode of transport.; The results demonstrate that some expensive technologies can be shown to have great efficacy, and that health care outcomes are subject to many other influences. Future changes in health care are postulated based on the outcome of the study.