Concentration of transfusion resources on a few pathologies and a few patients: analysis of the comprehensive in-hospital patient database.
BACKGROUND
Blood is a sparse commodity. Transfusion needs increase while the number of donors decreases. These constraints incite Belgian authorities to pay more attention to transfusion financing. This implies pathologic knowledge of the epidemiology of in-hospital transfusion and the consumption of blood products.


METHODS
This study is a retrospective analysis of in-hospital stays from the year 2000 and includes data from all 124 Belgian hospitals. The database contains information on diagnoses, procedures, and all-patients refined diagnosis-related groups (APRDRGs) but also on expenses linked to blood products transfused and to transfusion-related pharmaceutical products.


RESULTS
Three percent of surgical patients used 55.7 percent of transfusion resources and 75.4 percent of transfusion costs were associated with 24 APRDRGs. In the medical group, 3 percent of the patients accounted for 80.2 percent of transfusion costs and 20 APRDRGs consumed 71.9 percent of transfusion resources. The variables with the highest impact on the proportion of patients transfused were severity, pathology, and age. The effect of hospitals remained significant but had less impact. No substitution of blood products by transfusion-related pharmaceutical products was observed in our analysis.


CONCLUSIONS
Our study confirms that transfusion now centers on a limited number of pathologic entities and, within those, in small subsets of patients. This implies that the costs linked to setting up and running the transfusion system can no longer be shared by a large number of patients who receive transfusions but rely increasingly on patients at higher risks of more unpredictable needs. The system must nevertheless be able to cope with them at any time.
Beguin
Claire
C
Medical Information and Statistics and Anesthesiology of University Hospital Saint Luc and the Interdisciplinary Center of Health Economics of Catholic University of Louvain, Brussels, Belgium.
Closon
Marie-Christine
MC
Vandekerckhove
Philippe
P
Baele
Philippe
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium; D001771:Blood Banks / Q000191:economics / Q000706:statistics & numerical data; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data*; D001803:Blood Transfusion / Q000191:economics* / Q000706:statistics & numerical data*; D016208:Databases, Factual; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data*; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D019737:Transplants / Q000191:economics / Q000706:statistics & numerical data