Health economics of Patient Blood Management: a cost‐benefit analysis based on a meta‐analysis

Vox Sanguinis - Tập 115 Số 2 - Trang 182-188 - 2020
Patrick Meybohm1,2, Niels Straub3, Christoph Füllenbach1, Leonie Judd1, Adina Kleinerüschkamp4, Isabel Taeuber1, Kai Zacharowski1, Suma Choorapoikayil1
1Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt/Main, Germany
2Department of Anaesthesiology, University Hospital Wuerzburg, Wuerzburg, Germany
3Institute of Market Research, Statistics and Prognosis, Munich, Germany
4Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Helios University Hospital Wuppertal, Wuppertal, Germany

Tóm tắt

Background and ObjectivesPatient Blood Management (PBM) is the timely application of evidence‐based medical and surgical concepts designed to improve haemoglobin concentration, optimize haemostasis and minimize blood loss in an effort to improve patient outcomes. The focus of this cost‐benefit analysis is to analyse the economic benefit of widespread implementation of a multimodal PBM programme.Materials and MethodsBased on a recent meta‐analysis including 17 studies (>235 000 patients) comparing PBM with control care and data from the University Hospital Frankfurt, a cost‐benefit analysis was performed. Outcome data were red blood cell (RBC) transfusion rate, number of transfused RBC units, and length of hospital stay (LOS). Costs were considered for the following three PBM interventions as examples: anaemia management including therapy of iron deficiency, use of cell salvage and tranexamic acid. For sensitivity analysis, a Monte Carlo simulation was performed.ResultsIron supplementation was applied in 3·1%, cell salvage in 65% and tranexamic acid in 89% of the PBM patients. In total, applying these three PBM interventions costs €129·04 per patient. However, PBM was associated with a reduction in transfusion rate, transfused RBC units per patient, and LOS which yielded to mean savings of €150·64 per patient. Thus, the overall benefit of PBM implementation was €21·60 per patient. In the Monte Carlo simulation, the cost savings on the outcome side exceeded the PBM costs in approximately 2/3 of all repetitions and the total benefit was €1 878 000 in 100·000 simulated patients.ConclusionResources to implement a multimodal PBM concept optimizing patient care and safety can be cost‐effectively.

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Vox Sanguinis

Tập 115 Số 2

182-188

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