The management of minor-to-moderate bleeds extends beyond the initial line of treatment, and should include the economic impact of re-bleeding and failures over multiple lines of treatment. In the majority of cases, the rFVIIa-only regimen appears to be a less expensive treatment option in inhibitor patients with minor-to-moderate bleeds over three lines of treatment.

Background Trauma represents an important public health concern in the United Kingdom, yet the acute costs of blunt trauma injury have not been documented and analysed in detail. Knowledge of the overall costs of trauma care, and the drivers of these costs, is a prerequisite for a cost-conscious approach to improvement in standards of trauma care, including evaluation of the cost-effectiveness of new healthcare technologies.

SummaryUsing data from the Trauma Audit Research Network, we investigated the costs of acute care in patients ‡ 18 years of age hospitalised for traumatic brain injury between January 2000 and December 2005 in England and Wales. Traumatic brain injury patients were defined and stratified using the Abbreviated Injury Scale. A total of 6484 traumatic brain injury patients were identified; 22.3% had an Abbreviated Injury Scale score of three, 38.0% of four and 39.7% of five. Median age (IQR) was 42 years (28-59) and 76.7% were men. Primary cause of injury was motor vehicle collisions (42.4%) followed by falls (38.0%). In total 23.7% of the patients died before discharge. Hospitalisation costs averaged £15 462 (SD £16 844). Costs varied significantly by age, Glasgow Coma Score, Injury Severity Score, coexisting injuries of the thorax, spine and lower limb, hospital mortality, availability of neurosurgical services, and specialty of attendants seen in the Accident and Emergency department.

Background and Purpose: Stroke is the third leading cause of death in the UK, yet little information exists on current treatment patterns, outcomes and costs. This study assessed survival, readmissions and total hospital costs over 12 months in patients with first-ever intracerebral hemorrhage (ICH) or ischemic stroke (IS) in Scotland. Methods: Hospital-based retrospective inception cohort design using data from the Hospital Record Linkage System in the National Health Service in Scotland. Survival, readmissions and total hospital costs were evaluated in all patients admitted to hospital for ICH or IS from April 1, 2004, to March 31, 2005. Results: A total of 1,016 patients with ICH and 4,295 with IS were identified. The average age was 67.6 years (SD 14.5) for ICH and 70.4 years (SD 12.7) for IS at stroke onset. In-hospital mortality was 45.2% (95% confidence interval, CI, 41.0–49.3) for ICH and 15.6% (95% CI, 14.4–16.7) for IS, while 52.5% (95% CI, 48.0–56.9) and 27.2% (95% CI, 25.7–28.8), respectively, were dead at 1 year after stroke onset. The cumulative 1-year risk of rehospitalization for stroke and severe cardiac events was 15.0 and 1.0% in the ICH cohort, respectively, and 10.8 and 1.5% in the IS cohort. The average length of initial hospital stay was 38.4 days for ICH and 39.3 days for IS. The average total hospital costs over 12 months were GBP 13,960 (SD 21,487) for ICH and GBP 14,051 (SD 17,850) for IS. Conclusion: Individuals experiencing an ICH continue to exhibit a much worse prognosis than IS, and both forms of stroke continue to imply significant hospital costs to the National Health Service in Scotland.

This study estimated the annual cost of blood transfusions in the UK during 1994/1995. The analysis was based on published data, information derived from interviews with relevant NHS personnel and a purpose-designed structured questionnaire of blood donors. The cost to the UKs blood transfusion services of providing blood and blood products for transfusion was 165.5 Pounds million in 1994/1995. During this period, 2.75 million conventional donations of whole blood and 144,000 apheresis donations of platelets and plasma were collected: 2.58 million units of red blood cells were issued, resulting in approximately 866,000 red blood cell transfusions; 334,000 units of fresh frozen plasma and 1.16 million units of platelets were issued, resulting in approximately 17,000 and 188,000 isolated plasma and platelet transfusions, respectively. Hospital resource use attributable to providing blood transfusions during 1994/1995 cost the NHS 52.6 Pounds million. In total, blood transfusions cost the NHS 218.2 Pounds million during 1994/1995. Of this, red blood cell transfusions accounted for 76% of the annual cost, isolated platelet transfusions 16%, isolated plasma transfusions 1% and other products 7%. Donors incurred direct costs of 3.1 Pounds million and indirect costs of 11.2 Pounds million were accrued due to lost productivity. Additionally, blood donors gave up 2.5 million hours of their leisure time donating blood.