title: A cost-effectiveness analysis of the use of a mechanical barrier system to reduce the risk of mistransfusion.
abstract: BACKGROUND
  A blood component is transfused to a patient other than the intended recipient because of patient and sample identification problems once in about every 24,000 transfusions. An investigation was performed of the cost-effectiveness of a barrier system to prevent mistransfusion of a unit of red cells through this kind of error.
  
  
  METHODS
  A decision analysis model was constructed that took into account nonfatal and fatal events, costs of patient care, and legal costs. The model was used to determine the cost-effectiveness of the barrier system in terms of cost per year of life saved and lives saved per million transfusions.
  
  
  RESULTS
  The barrier system is predicted to save 1.5 lives per million transfusions when used as intended. If the cost-effectiveness calculations are based on an average damage award for a fatality of more than $725,000 and a chance of mistransfusion exceeding 1 in 16,700, use of the system results in reduced healthcare expenditures. If no legal costs are included in the cost-effectiveness calculations, use of the system costs $197,000 per year of life saved. Routine use of the system extends patient life by 1 year per 60,000 units transfused.
  
  
  CONCLUSIONS
  The application of a barrier system to prevent mistransfusion and related morbidity and mortality can be cost-effective. If legal costs are included in the calculations, the use of a barrier system reduces total costs.
authors.affiliation: Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
authors.forename: J P
authors.initials: JP
authors.lastname: AuBuchon
authors.forename: B
authors.initials: B
authors.lastname: Littenberg
mesh_terms: D001787:Blood Group Incompatibility / Q000517:prevention & control*; D001803:Blood Transfusion; D003362:Cost-Benefit Analysis; D006801:Humans; D016365:Liability, Legal / Q000191:economics; D010355:Patient Identification Systems / Q000191:economics*