Maryland's medevac program this year implemented changes designed to reduce unnecessary use of state police helicopters, a senior official told lawmakers in Annapolis this morning.
Patients who are within a 30-minute drive to a trauma center must now be transported by ambulance, unless there are "extenuating" circumstances, said Dr. Robert R. Bass, head of Maryland's emergency medical response network.
He also said paramedics will no longer automatically send to trauma centers patients who have been involved in automobile roll-over accidents, high-speed crashes, vehicle extractions lasting longer than 20 minutes and other situations that were formerly believed to indicate a high likelihood of serious injury.
Bass, speaking to the Joint Committee on Health Care Delivery and Financing, was defending his agency's performance in light of statistics showing that almost half of the patients flown by helicopter to Maryland trauma centers are released within 24 hours - suggesting many of them may not have needed the costly helicopter flight.
Between 4,500 and 5,000 patients are transported to hospitals by the state's medevac unit every year, at a cost to taxpayers of about $4,000 per trip, Bass said.
The hearing, called by Del. Dan K. Morhaim, a Baltimore County Democrat and co-chairman of the committee, was also prompted in part by a legislative audit last month that was critical of the Maryland State Police's fiscal management and maintenance of the program's aging 12-helicopter fleet.
Morhaim, a former emergency room physician, praised Bass for taking steps designed to improve the medevac system's efficiency. But he and other legislators said the program's high cost and possibly "marginal" benefit to patients was still a concern at a time when politicians are looking for ways to cut the state budget.
"Clearly, you can't put a dollar value on saving a life," said Sen. Rob Garagiola, a Montgomery County Democrat and committee co-chairman.
"But we've got to make decisions in tight fiscal times," Garagiola added, referring to a list of currently underfunded health care programs, such as preventive care for mental health patients. "Can we use some [medevac] dollars for other aspects of the health care system?"
Morhaim questioned the value of helicopter transports, pointing out a recent review of scientific literature that concluded that there was "no measurable health benefit" to patients transported by air.
