Economic analysis of the implementation of autologous transfusion technologies throughout England.
OBJECTIVE
This study aims to provide the first estimates of the costs and effects of the large scale introduction of autologous transfusion technologies into the United Kingdom National Health Service.


METHODS
A model was constructed to allow disparate data sources to be combined to produce estimates of the scale, costs, and effects of introducing four interventions. The interventions considered were preparing patients for surgery (PPS) clinics, preoperative autologous donation (PAD), intraoperative cell salvage (ICS), and postoperative cell salvage (PoCS).


RESULTS
The key determinants of cost per operation are the anticipated level of reductions in blood use, the mean level of blood use, mean length of stay, and the cost of the technology. The results show the potential for considerable reductions in blood use. The greatest reductions are anticipated to be through the use of PPS and ICS. Vascular surgery, transplant surgery, and cardiothoracic surgery appear to be the specialties that will benefit most from the technologies.


CONCLUSIONS
Several simplifications were used in the production of these estimates; consequently, caution should be used in their interpretation and use. Despite the drawbacks in the methods used in the study, the model shows the scale of the issue, the importance of gathering better data, and the form that data must take. Such preliminary modeling exercises are essential for rational policy development and to direct future research and discussion among stakeholders.
Dixon
Simon
S
School of Health and Related Research, University of Sheffield, South Yorkshire, UK. s.dixon@shef.ac.uk
James
Virge
V
Hind
Daniel
D
Currie
Craig J
CJ
D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous / Q000191:economics* / Q000295:instrumentation / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D004059:Diffusion of Innovation; D017721:Hospital Costs; D006784:Hospitals, Teaching / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D017059:Models, Econometric; D013222:State Medicine / Q000191:economics*; D013514:Surgical Procedures, Operative / Q000145:classification / Q000191:economics*; D013673:Technology Assessment, Biomedical; D014852:Wales