Objectives: Since there is little literature on the cost-effectiveness of different infant, pediatric and maternal transport team(ITT) models in current use, we compared costs and outcomes of the Emergency Medical Technician (EMT) based but physician supported ITT team in British Columbia with two other commonly used models in North America: dedicated nurse teams (RN), and combined physician/nurse/respiratory therapist teams (CT).

Methods: We examined ITT utilization data for 1994 in British Columbia, and applied B.C. costs to derive comparative costs for the three models. Cost calculations included administrative costs, annualized training costs and wages (all EMT wages were included, but wages for nurses, physicians and respiratory therapists were pro-rated to reflect actual transport times). The Alberta Neonatal Transport Stabilization Score (ANTSS) was used to compare outcomes of the EMT team (B.C.) with published data from a CT team(Alberta).

Sensitivity analysis assumptions: LOW - 20% reduction in patient stabilization time with RN and CT models; HIGH - all transport team RN and RT wages included (i.e. not pro-rated)

Results: See Table 1. ANTSS scores for the EMT and CT teams were similar.

Table 1 Costs and ANTSS scores for transport team models
Full size table

Conclusion: The EMT model is least costly, most flexible, and has outcomes similar to the CT model.