title: Economic analysis of an intraoperative cell salvage service.
abstract: In the United States, the cost of erythrocyte transfusion exceeds 1.3 billion dollars annually. The fear of viral disease transmission popularized intraoperative salvage to reduce the use of banked blood. Although the economics of this technique have been questioned, the financial variables in providing an intraoperative autotransfusion service have not been analyzed. We designed mathematical models to determine the most cost-effective strategy based on hospital caseload. Four models were analyzed with a spreadsheet to project costs of an intraoperative autotransfusion service when fully or partially outsourced, performed by a full-time technician employee, or performed by a cross-trained employee. The Partially Outsourced model was more economical than the Fully Outsourced model when the annual caseload exceeded 185 cases. The New Employee model became more economical than the Fully Outsourced model when the annual caseload exceeded 110 cases. The Cross-Trained model was the most economical when annual caseload exceeded 55 cases.
  
  
  CONCLUSIONS
  Cross-training an employee as a cell salvage technician is more economical than outsourcing when caseload exceeds 55 per year.
authors.affiliation: *Anesthesia Department, Naval Hospital Rota, Spain; †Department of Anesthesiology, Uniform Services University of the Health Sciences, Bethesda, Maryland; ‡Department of Anesthesiology, Dunlap Memorial Hospital, Orrville, Ohio; and §Federal Medical Center, Butner, North Carolina.
authors.forename: Dale F
authors.initials: DF
authors.lastname: Szpisjak
authors.forename: Paul S
authors.initials: PS
authors.lastname: Potter
authors.forename: Bruce P
authors.initials: BP
authors.lastname: Capehart
mesh_terms: D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous / Q000191:economics* / Q000295:instrumentation; D003362:Cost-Benefit Analysis; D016208:Databases, Factual; D017707:Erythrocyte Transfusion / Q000191:economics* / Q000295:instrumentation; D016014:Linear Models; D015233:Models, Statistical