A cost and outcomes comparison of a novel integrated pediatric air and ground transportation system

Shawn D. Safford, Thomas Z. Hayward, Kristine M. Safford, Gregory S. Georgiade, Henry E. Rice, Michael A. Skinner

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

BACKGROUND: The purpose of this study is to compare air transportation of critically ill pediatric patients with a mixed air-ground transportation system by evaluating timeliness, safety, and cost. The setting was a tertiary care "hub" center with three outlying-referral "spoke" facilities. STUDY DESIGN: Our study included 96 children transported between June and December 1997, with 45% constituting surgical admissions and 55% medical admissions. Data collected at the outlying facilities, en route, and at our institution included vital signs, laboratory values, and Glasgow coma scores. We evaluated transport time, transport cost, Pediatric Risk of Mortality scores, and Pediatric Index of Mortality of the children during transportation using ANOVA statistical analysis. We also compared adverse events in transportation, total hospital length of stay, and mortality at 24 and 72 hours in both the air and ground transport groups to determine differences in predicted and observed mortality. RESULTS: A total of 96 children were transported (48% by ground and 52% by air) between June and December 1997. The time at the referring facility was significantly shorter in the ground group than in the air group (air, 55.4 minutes versus ground, 36.7 minutes, p < 0.01). Total transport time differed by only 27 minutes between groups. No difference was identified in morbidity or mortality between air and ground groups. Actual mortality was not significantly different from predicted mortality in either group. The cost of ground transportation was significantly lower (air, $4,236 versus ground, $1,566). When our system of a combined air and ground group transport system is compared with a hypothetical 100% air transport system, we saved an average of more than $240,000 annually. CONCLUSIONS: We have demonstrated that a "hub-and-spoke" ground transportation system supplements air transportation in a safe, timely, and cost-effective manner.

Original languageEnglish (US)
Pages (from-to)790-795
Number of pages6
JournalJournal of the American College of Surgeons
Volume195
Issue number6
DOIs
StatePublished - Dec 1 2002

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Air
Pediatrics
Costs and Cost Analysis
Mortality
Length of Stay
Child Mortality
Vital Signs
Coma
Hospital Mortality
Tertiary Care Centers
Critical Illness
Analysis of Variance
Referral and Consultation
Morbidity
Safety

ASJC Scopus subject areas

  • Surgery

Cite this

Safford, S. D., Hayward, T. Z., Safford, K. M., Georgiade, G. S., Rice, H. E., & Skinner, M. A. (2002). A cost and outcomes comparison of a novel integrated pediatric air and ground transportation system. Journal of the American College of Surgeons, 195(6), 790-795. https://doi.org/10.1016/S1072-7515(02)01489-8

A cost and outcomes comparison of a novel integrated pediatric air and ground transportation system. / Safford, Shawn D.; Hayward, Thomas Z.; Safford, Kristine M.; Georgiade, Gregory S.; Rice, Henry E.; Skinner, Michael A.

In: Journal of the American College of Surgeons, Vol. 195, No. 6, 01.12.2002, p. 790-795.

Research output: Contribution to journalArticle

Safford, Shawn D. ; Hayward, Thomas Z. ; Safford, Kristine M. ; Georgiade, Gregory S. ; Rice, Henry E. ; Skinner, Michael A. / A cost and outcomes comparison of a novel integrated pediatric air and ground transportation system. In: Journal of the American College of Surgeons. 2002 ; Vol. 195, No. 6. pp. 790-795.
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