en Public Administration & Health management and economics Public Administration & Health management and economics Original Research Original Research <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><b><span style="font-size:9.0pt"><span style="font-style:normal">Background: </span></span></b><span style="font-size:9.0pt"><span style="font-style:normal">The prehospital emergency system is the first initiator of medical care as an alternative to hospitals and health care services that helps patients and injured people in critical situations and accidents. This study aimed to evaluate the cost-effectiveness of air ambulance versus ground ambulance regarding the patient&rsquo;s transportation and treatment. </span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Methods: </b>In this cost-effectiveness analysis study, 300 patients who were transferred to the Shohadaye HaftomTir hospital by air ambulance and 300 patients transferred by ground ambulance during the study period were selected in 2021-2022. This study examined the costs from the society&rsquo;s perspective. After drawing the decision tree model in TreeAge software, the incremental cost-effectiveness ratio was calculated; and to evaluate the strength of the analysis results, one-way and two-way sensitivity analyses were done on all costs and consequence parameters. </span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Results:</b> The effectiveness rate in the ground ambulance group and in the air ambulance group was 0.42591 and 0.5566, respectively, and the total cost of transportation and treatment by ambulance in these patients was $412.88 and for patients transported and treated by air ambulance was $11898.05. Therefore, air ambulance costs more and is more effective than ground ambulance, and the amount of incremental cost and effectiveness of air ambulance compared with ground ambulance was $11485.17 and 0.130773 units, respectively. The incremental cost-effectiveness ratio (ICER) of the 2 strategies was 87825.28, and the cost-effectiveness threshold was $7200. To determine the strength of the study results, one-way and two-way sensitivity analyses were done and the results of the cost-effectiveness analysis was not changed.</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Conclusion: </b>Our study showed that ground ambulance is more cost-effective than air ambulance and the most important reason is that the total cost of air ambulance is 26 times more than ground ambulance, however, it is more effective than ground ambulance. </span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic">&nbsp;</span></span></span></span></span></span><br> &nbsp; Cost-Effectiveness, Air Emergency, Ambulance 861 867 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-3266-8&slc_lang=en&sid=1 Nader Tavakoli tavakoli.n@iums.ac.ir 200319475328460072764 200319475328460072764 No Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran Peyman Saberian md.saberian.p@gmail.com 200319475328460072765 200319475328460072765 No Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran Saeed Bagheri Faradonbeh s.bagheri88@yahoo.com 200319475328460072766 200319475328460072766 No Department of Health Services Management, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Parisa Hasani Sharamin parisahasaniems@gmail.com 200319475328460072767 200319475328460072767 No Tehran Emergency Medical Service Center, Tehran, Iran Maryam Modaber m.modabber313@gmail.com 200319475328460072768 200319475328460072768 No Tehran Emergency Medical Service Center, Tehran, Iran Zahra Sohrabi Anbohi z.sohrabi.a@gmail.com 200319475328460072769 200319475328460072769 No Iran University of Medical Sciences, Tehran, Iran Razieh Jamshidi j.razie96@gmail.com 200319475328460072770 200319475328460072770 No Iran University of Medical Sciences, Tehran, Iran Majid Abedinejad majidems1365@gmail.com 200319475328460072771 200319475328460072771 No Iran University of Medical Sciences, Tehran, Iran Pirhossein Kolivand peirhossein@yahoo.com 200319475328460072772 200319475328460072772 Yes Department of Health Economics, Faculty of Medicine, Shahed University, Tehran, Iran