A cost-analysis study of using adult red cell packs and Pedi-Packs in newborn intensive care units in Southern Iran

Abstract

Background and objective Saving blood products is an important public health issue especially in developing countries with limited financial resources. We aimed to suggest a new hypothetical model to make a change in the current blood transfusion policy in the newborn intensive care unit (NICU) to reduce wastage of blood supplies as well as the risk of exposure to multiple donors. Methods In this cross-sectional study, all transfused neonates (n = 70) who were admitted to NICU of Nemazee Hospital, a tertiary referral hospital in Southern Iran, were evaluated between March and June 2019. Based on the information of neonates’ transfusion during this study period and determined transfusion indices, a specific pediatric pack was suggested and the related total costs per transfusion, as well as the donor-exposure rate of the hypothetical and the current transfusion method, were compared. Results Considering the mean number of transfusions per neonate: 4 and mean volume of transfused packed red cells: 20 ml per transfusion, the cost-analysis of pediatric and the adult pack was presented. Arithmetically, we proved a higher total cost per transfusion for using adult pack comparing to pediatric pack. Additionally, using a pediatric pack set leads to a 24% reduction in RBCs wastage per transfusion and a 68.13% reduction in donor-exposure rate. Conclusions The assignment of a dedicated pediatric pack for neonates will be able to improve the cost-effectiveness by a substantial reduction in donor-exposure rate and blood wastage. This finding should be taken into consideration to generate economic growth and make improvements in child health status.

The appearance and increase in the quantity and proportion of the clinical research coordinator’s service fee in drug clinical trial research fund and its impact on trial quality

“…A cost increase of drug clinical trial is necessary for quality improvement, but it is not a sufficient condition. Every relevant aspect should be well regulated and managed, which in turn is economically important particularly in developing countries with a shortage in financial resources [ 19 ]. If one aspect is neglected or incomplete, the cost increase is not positively correlated with quality improvement, and certain factors that raise prices can improve quality in some ways, while obstructing quality improvement in other ways.…”