Costs of blood transfusion: a process-flow analysis.
OBJECTIVE
To determine the cost of transfusing 2 units (U) of packed RBCs at a comprehensive cancer center.


METHODS
We performed a process-flow analysis to identify all costs of transfusing 2 U of allogeneic packed RBCs on an outpatient basis to patients with either (1) solid tumor who did not undergo bone marrow transplantation (BMT), (2) solid tumor who underwent BMT, (3) hematologic malignancy who did not undergo BMT, (4) hematologic malignancy who underwent allogeneic BMT, or (5) hematologic malignancy who underwent autologous BMT. We conducted structured interviews to determine the personnel time used and physical resources necessary at all steps of the transfusion process.


RESULTS
The mean cost of a 2-U transfusion of allogeneic packed RBCs was $548, $565, $569, $569, and $566 for patients with non-BMT solid tumor, BMT solid tumor, non-BMT hematologic malignancy, allogeneic BMT hematologic malignancy, and autologous BMT hematologic malignancy, respectively. Sensitivity analysis showed that total transfusion costs were sensitive to variations in the amount of clinician compensation and overhead costs, but were relatively insensitive to reasonable variations in the direct costs of blood tests and the blood itself, or the probability or extent of transfusion reaction.


CONCLUSIONS
The costs of the transfusion of packed RBCs are greater than previously analyzed, particularly in the cancer care setting.
Department of Medical Specialties, Ambulatory and Supportive Care Oncology Research Program, University of Texas M.D. Anderson Cancer Center, Houston 77030-4095, USA. sbcantor@mdanderson.org
S B
SB
Cantor
D V
DV
Hudson
B
B
Lichtiger
E B
EB
Rubenstein
D000066:Accounting; D000553:Ambulatory Care; D001771:Blood Banks / Q000191:economics*; D016026:Bone Marrow Transplantation / Q000191:economics*; D002173:Cancer Care Facilities / Q000191:economics*; D003361:Cost Allocation; D017707:Erythrocyte Transfusion / Q000191:economics*; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D009369:Neoplasms / Q000191:economics* / Q000628:therapy; D017064:Process Assessment, Health Care / Q000191:economics*; D013647:Task Performance and Analysis; D013781:Texas