Aeromedical Patient Transfer in a High-volume Health System: Centralised Coordination and Governance in Türkiye

Aeromedical patient transfer plays a crucial role in ensuring continuity of time-sensitive care in health systems characterized by high patient volumes, geographic diversity, and regional disparities in access to healthcare. This review examines the core organizational and governance principles of aeromedical patient transfer systems and evaluates the centrally coordinated aeromedical model implemented in Türkiye, in the context of the global literature, to generate context-sensitive policy insights for high-volume health systems. A narrative, policy-informed review approach was adopted. The global literature on aeromedical patient transfer was examined, with a focus on organizational models, central coordination mechanisms, clinical prioritization, medical leadership, and safety-oriented governance. Türkiye’s air ambulance system was analyzed against national regulatory frameworks and operational structures and contextualized through comparison with international practices. Türkiye has developed a centrally coordinated aeromedical model integrating air ambulance services into the national emergency medical services system. The model is characterized by centralized decision-making, standardized clinical indications, strong medical leadership, and systematic integration of operational safety and risk management. Aeromedical resources are treated as limited, high-value health assets, with deployment guided by clinical benefit and system-level priorities rather than transport speed alone. The Turkish experience suggests that the effectiveness of aeromedical patient transfer in high-volume health systems depends more on governance, coordination, and rational resource allocation than on fleet size or technological capacity. While not intended for direct replication, this centrally coordinated model offers adaptable principles that may support coordinated access to specialized care in other middle-income countries