Red blood cell (RBC) transfusions can alleviate symptoms like fatigue, dyspnea, and cardiac problems. This research aims at identifying, measuring, and valuing health care resources and activities needed to provide RBC transfusions in Italy. An empirical, retrospective cost description of the RBC transfusion process was performed following the viewpoint of a large Italian Local Health Authority based in Florence, Italy. Activity based costing (ABC) and traditional cost (direct costs plus a share of indirect costs) methods were applied. The RBC transfusion process was divided into 3 episodes (donation, processing, and transfusion) and 13 activities. Costs (in € 2008) were grouped in 5 categories (labor, disposables, lab tests, equipment, other costs). Costs for managing transfusion-related risks were not considered. The full cost for RBC transfusions is € 482.1 (donation: € 113.6; processing € 233.3; transfusion € 135.2) and € 346.9 for RBC units. ABC highlights that the most and the least expensive activities are quality assessment (€ 191.9) and waste management (€ 0.3). Labor is the most relevant cost item of the full cost for RBC transfusion. Pharmacologic research aiming at increasing the number of RBC transfusion-free patients should take into account, together with other parameters, also the real RBC transfusion costs
3817 Background: For the majority of patients (pts) with myelodysplastic syndromes (MDS), anemia is the principal cause of symptoms. Red blood cell (RBC) transfusion can alleviate fatigue, dyspnea, and cardiac problems in anemic pts. Approximately 80% of pts with MDS are anemic at the time of presentation and more than 40% require regular RBC transfusions at some stage of disease (Brechignac, Blood, 2004;A4716). Cost of blood products is one of the most uncontrollable items in the budget of MDS care. Aims: This study was performed to identify, measure, and assess the health care activities and resources needed to provide RBC transfusions, and to determine their costs. Methods: This cost analysis was performed from the perspective of health care providers, according to the Activity Based Costing (ABC) method (Asadi, J Soc Health Syst,1996). ABC systems focus on activities involved in the delivery of care. Under the ABC system, costs are first traced to activities and then traced from the activities to units of episodic care using cost drivers based on the consumption of activity resources (Udpa, Manag Care Q, 2001). This analysis was performed within Florence Italy's Local Health Authority (ASL 10; 813,419 members, 48% male, 2008), at OSMA Transfusion Center, with scientific support from the Hematology Unit of AOU Careggi University Hospital, Florence. All transfusions were performed in an outpatient ambulatory setting and no hospitalizations (for any cause) were considered in the analysis. A “self-reporting” approach (Burke, J Nurse Admin, 2000) was used to collect resource utilization data. According to the ABC method, the transfusion procedure was described in terms of episodes that encompass macro-activities and micro-activities (Casati, McGraw-Hill, 2002) and are represented in a process-flow diagram. All professionals involved in providing RBC transfusions participated in structured interviews and validated the flow chart generated to represent the process. Human, material, and capital resources were described, and their unitary costs provided by the OSMA Cost and Performance Management Office, for the year 2008. Episodes identified were: RBC donation, processing, and transfusion, each subdivided into macro-activities and micro-activities amenable to economic assessment. Macro-activities identified for donation included: admission, clinic visit, donation, and discharge; for processing: centrifugation, separation of blood elements, and storage; and for transfusion: pt admission, compatibility testing, distribution, transfusion, and waste management. Micro-activities were evaluated according to the professional who performed the task and the time and materials required. Unit costs were attributed to resources as follows: Results: The total average cost of the 3 episodes for RBC transfusion was |CE492.57, divided as follows: 1) donation: |CE116.02; 2) processing |CE233.29; 3) transfusion |CE135.16, and 4) overhead |CE8.10. Cost distribution is shown in the Table. The cost of a single RBC unit was |CE349.31. OSMA-Florence Transfusion Center managed 7,994 RBC units in 2008, from which the Hematology section performed an average of 23 transfusions per week (4.6 per day). Conclusion: RBC transfusion is an essential and life-saving intervention for anemic patients. The economic burden of transfusions comprises 2 dimensions: costs to perform transfusion and costs associated with management of transfusion-related risks (eg, iron overload, transmitted infections, adverse effects attributable to immune mechanisms) (Alessandrino, Blood, 2002). Our analysis quantitates costs for the first dimension, providing direct and indirect costs of RBC transfusion. Disclosures: No relevant conflicts of interest to declare.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.