title: [Health economic aspects of the use of blood and blood products].
abstract: An adequate supply of blood components for patients depends on the population's willingness to donate blood as well as on a well-organized blood donation system. In order to ensure the blood supply, a high expenditure is necessary. The article at hand describes two areas of the use of blood and blood products. First, it considers the application of factor concentrates in haemophiliacs (approximately 3000-4000 patients are regularly in need of treatment). For the German statutory health insurance, the estimated yearly expenses for factor concentrates is approx. 450 million Euros, the average costs per patient and year and per treatment center range between 40,903 and 117,597 Euros. The costs for an immune tolerance therapy (ITT) for patients with inhibitors are estimated to be between 70,300 and 3,800,000 Euros for children, depending on the length of the therapy and the degree of severity. In the second part of the article, the authors outline the status quo of the economic evaluation of cellular blood products and present the results of a German cross-sectional survey on the use of erythrocytes in orthopaedic surgery. Within the scope of this hemotherapy study, the transfusion rates vary considerably within the participating treatment centers [elective hip joint replacement (THR): 17 and 94%]. The average blood loss also differs significantly. Comparing the treatment centers, the calculated blood loss during THR shows considerable differences (median blood loss in treatment center with lowest/treatment center with highest blood loss: 883 ml/2,975 ml). The acceptance of low intraoperative hemoglobin values in the clinics is high and diverse. These differences in transfusion procedures between the treatment centers clearly show the need to take effective action in the area of quality assurance in order to make the most of the existent savings potential. Transparency of treatment processes is a necessary condition for an economic assessment and for optimal resource allocation.
authors.affiliation: Klinikum der Universität München.
authors.forename: K
authors.initials: K
authors.lastname: Berger
authors.forename: L
authors.initials: L
authors.lastname: Frey
authors.forename: M
authors.initials: M
authors.lastname: Spannagl
authors.forename: W
authors.initials: W
authors.lastname: Schramm
mesh_terms: D001771:Blood Banks / Q000191:economics / Q000706:statistics & numerical data; D001802:Blood Substitutes / Q000191:economics* / Q000600:supply & distribution*; D001803:Blood Transfusion / Q000191:economics* / Q000706:statistics & numerical data*; D002908:Chronic Disease; D003362:Cost-Benefit Analysis / Q000379:methods; D003657:Decision Making; D003661:Decision Support Techniques; D003695:Delivery of Health Care / Q000191:economics*; D004470:Economics, Medical; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D018803:Models, Economic
chemical_list: D001802:Blood Substitutes