Premium
Increased hospital costs associated with red blood cell transfusion
Author(s) -
Trentino Kevin M.,
Farmer Shan L.,
Swain Stuart G.,
Burrows Sally A.,
Hofmann Axel,
Ienco Rinaldo,
Pavey Warren,
Daly Frank F.S.,
Van Niekerk Anton,
Webb Steven A.R.,
Towler Simon,
Leahy Michael F.
Publication year - 2015
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.12958
Subject(s) - medicine , emergency medicine , confidence interval , blood transfusion , confounding , intensive care unit , incidence (geometry) , retrospective cohort study , acute care , health care , intensive care medicine , physics , optics , economics , economic growth
Background Red blood cell ( RBC ) transfusion is independently associated in a dose‐dependent manner with increased intensive care unit stay, total hospital length of stay, and hospital‐acquired complications. Since little is known of the cost of these transfusion‐associated adverse outcomes our aim was to determine the total hospital cost associated with RBC transfusion and to assess any dose‐dependent relationship. Study Design and Methods A retrospective cohort study of all multiday acute care inpatients discharged from a five hospital health service in W estern A ustralia between J uly 2011 and J une 2012 was conducted. Main outcome measures were incidence of RBC transfusion and mean inpatient hospital costs. Results Of 89,996 multiday, acute care inpatient discharges, 4805 (5.3%) were transfused at least 1 unit of RBCs . After potential confounders were adjusted for, the mean inpatient cost was 1.83 times higher in the transfused group compared with the nontransfused group (95% confidence interval, 1.78‐1.89; p < 0.001). The estimated total hospital‐associated cost of RBC transfusion in this study was AUD $77 million ( US $72 million), representing 7.8% of total hospital expenditure on acute care inpatients. There was a significant dose‐dependent association between the number of RBC units transfused and increased costs after adjusting for confounders. Conclusion RBC transfusions were independently associated with significantly higher hospital costs. The financial implication to hospital budgets will assist in prioritizing areas to reduce the rate of RBC transfusions and in implementing patient blood management programs.