Background Helicopter emergency services (HEMS) are of increasing relevance for emergency medical services (EMS) of developed countries. Despite the known cost intensity of HEMS, there is only very limited knowledge of its cost dynamics and structures. This averts an efficient resource allocation of scarce EMS resources in an environment that is characterized by socio-political, medical and economic challenges. The objective of this study is the exemplary modeling of HEMS cost structures. Methods We defined three scenarios with each five variations to illustrate different models of HEMS provision. Into these, we included varying availability times, technical features for off-shore or alpine rescue and differing numbers of operations. Cost data is based on a broad literature review and primary data from a German HEMS organization resulting in a cost function. We calculated average costs per primary missions and total costs, whilst differentiating between fixed, jump-fixed, variable and maintenance costs for every scenario variation. The costs were further used to evaluate the profitability of operations by executing a break-even analysis. Results Average costs per HEMS operation decrease with increasing number of operations due to the digression of fixed costs. Depending on special equipment, availability times or other assumptions, total costs differ significantly with the different scenario variations. For the basic scenario (12 h of operations per day), the total costs per year of HEMS are 1,697,546.20 € and the unit costs are 763.41 € per primary mission at 1200 primary and 92 secondary operations. At an engine-runtime based revenue of 70 € per minute, global cost covering is possible after 728 missions (c.p.). Conclusions Considering a revenue of 70 € per minute of engine run-time, HEMS can be operated at a profit for companies. However, the necessary remuneration represents a high financial effort for the societal cost bearers of helicopter emergency services. This leads to the question of the cost-benefit ratio of HEMS, which could be approached in further researches by using this model. The valuation of mission costs also opens a new view to the framework of HEMS disposition procedures and criteria. This cost analysis enhances the necessity of better planning of HEMS networks to use available resources efficiently in order to improve social welfare.

中文翻译：

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直升机紧急服务的成本计算-以德国农村地区为例的战略模拟

背景技术直升机紧急服务（HEMS）与发达国家的紧急医疗服务（EMS）的相关性越来越高。尽管已知HEMS的成本强度，但对其成本动态和结构的了解非常有限。在以社会政治，医疗和经济挑战为特征的环境中，这避免了稀有EMS资源的有效资源分配。这项研究的目的是对HEMS成本结构进行建模。方法我们定义了三种方案，每一种方案都有五个变体，以说明HEMS提供的不同模型。其中，我们包括了不同的可用时间，近海或高山救援的技术功能以及不同的操作次数。成本数据是基于广泛的文献综述以及来自德国HEMS组织的原始数据得出的成本函数。我们计算了每个主要任务的平均成本和总成本，同时区分了每种方案变化的固定成本，跳跃固定成本，可变成本和维护成本。通过执行盈亏平衡分析，这些成本进一步用于评估运营的盈利能力。结果由于固定成本的偏离，每项HEMS运营的平均成本随着运营次数的增加而降低。根据特殊设备，可用时间或其他假设，总成本会随方案的变化而显着不同。对于基本方案（每天运行12小时），HEMS每年的总成本为1,697,546.20欧元，单位成本为763。每个主要任务41欧元，在1200个主要任务和92个次要任务中。以每分钟70欧元的发动机运行时间为基础，在执行728次任务（cp）之后，就可以覆盖全球成本。结论考虑到每分钟70欧元的发动机运行收入，HEMS可以为公司带来利润。但是，对于直升机紧急服务的社会成本承担者来说，必要的报酬代表了巨大的财务努力。这导致了HEMS的成本效益比问题，可以通过使用该模型在进一步的研究中加以探讨。特派团费用的估值也为HEMS处置程序和标准的框架开辟了新视野。这项成本分析增加了对HEMS网络进行更好规划的必要性，以有效地使用可用资源以改善社会福利。