Increased hospital costs associated with red blood cell transfusion

K.M. Trentino, Shannon Farmer, S.G. Swain, Sally Burrows, Axel Hofmann, R. Ienco, W. Pavey, Frank Daly, A. Van Niekerk, Steve Webb, S. Towler, Michael Leahy

Research output: Contribution to journalArticle

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Abstract

Background: Red blood cell (RBC) transfusion is independently associated in a dose-dependent manner with increased intensive care unit stay, total hospital length of stay, and hospital-acquired complications. Since little is known of the cost of these transfusion-associated adverse outcomes our aim was to determine the total hospital cost associated with RBC transfusion and to assess any dose-dependent relationship.

Study Design and Methods: A retrospective cohort study of all multiday acute care inpatients discharged from a five hospital health service in Western Australia between July 2011 and June 2012 was conducted. Main outcome measures were incidence of RBC transfusion and mean inpatient hospital costs.

 Results: Of 89,996 multiday, acute care inpatient discharges, 4805 (5.3%) were transfused at least 1 unit of RBCs. After potential confounders were adjusted for, the mean inpatient cost was 1.83 times higher in the transfused group compared with the nontransfused group (95% confidence interval, 1.78-1.89; p <0.001). The estimated total hospital-associated cost of RBC transfusion in this study was AUD $77 million (US $72 million), representing 7.8% of total hospital expenditure on acute care inpatients. There was a significant dose-dependent association between the number of RBC units transfused and increased costs after adjusting for confounders.

Conclusion: RBC transfusions were independently associated with significantly higher hospital costs. The financial implication to hospital budgets will assist in prioritizing areas to reduce the rate of RBC transfusions and in implementing patient blood management programs.

Original languageEnglish
Pages (from-to)1082-1089
JournalTransfusion
Volume55
Issue number5
DOIs
Publication statusPublished - May 2015

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Erythrocyte Transfusion
Hospital Costs
Inpatients
Costs and Cost Analysis
Length of Stay
Western Australia
Budgets
Health Expenditures
Health Services
Intensive Care Units
Cohort Studies
Retrospective Studies
Erythrocytes
Outcome Assessment (Health Care)
Confidence Intervals
Incidence

Cite this

Trentino, K.M. ; Farmer, Shannon ; Swain, S.G. ; Burrows, Sally ; Hofmann, Axel ; Ienco, R. ; Pavey, W. ; Daly, Frank ; Van Niekerk, A. ; Webb, Steve ; Towler, S. ; Leahy, Michael. / Increased hospital costs associated with red blood cell transfusion. In: Transfusion. 2015 ; Vol. 55, No. 5. pp. 1082-1089.
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abstract = "Background: Red blood cell (RBC) transfusion is independently associated in a dose-dependent manner with increased intensive care unit stay, total hospital length of stay, and hospital-acquired complications. Since little is known of the cost of these transfusion-associated adverse outcomes our aim was to determine the total hospital cost associated with RBC transfusion and to assess any dose-dependent relationship. Study Design and Methods: A retrospective cohort study of all multiday acute care inpatients discharged from a five hospital health service in Western Australia between July 2011 and June 2012 was conducted. Main outcome measures were incidence of RBC transfusion and mean inpatient hospital costs. Results: Of 89,996 multiday, acute care inpatient discharges, 4805 (5.3{\%}) were transfused at least 1 unit of RBCs. After potential confounders were adjusted for, the mean inpatient cost was 1.83 times higher in the transfused group compared with the nontransfused group (95{\%} confidence interval, 1.78-1.89; p <0.001). The estimated total hospital-associated cost of RBC transfusion in this study was AUD $77 million (US $72 million), representing 7.8{\%} of total hospital expenditure on acute care inpatients. There was a significant dose-dependent association between the number of RBC units transfused and increased costs after adjusting for confounders. Conclusion: RBC transfusions were independently associated with significantly higher hospital costs. The financial implication to hospital budgets will assist in prioritizing areas to reduce the rate of RBC transfusions and in implementing patient blood management programs.",
author = "K.M. Trentino and Shannon Farmer and S.G. Swain and Sally Burrows and Axel Hofmann and R. Ienco and W. Pavey and Frank Daly and {Van Niekerk}, A. and Steve Webb and S. Towler and Michael Leahy",
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Trentino, KM, Farmer, S, Swain, SG, Burrows, S, Hofmann, A, Ienco, R, Pavey, W, Daly, F, Van Niekerk, A, Webb, S, Towler, S & Leahy, M 2015, 'Increased hospital costs associated with red blood cell transfusion' Transfusion, vol. 55, no. 5, pp. 1082-1089. https://doi.org/10.1111/trf.12958

Increased hospital costs associated with red blood cell transfusion. / Trentino, K.M.; Farmer, Shannon; Swain, S.G.; Burrows, Sally; Hofmann, Axel; Ienco, R.; Pavey, W.; Daly, Frank; Van Niekerk, A.; Webb, Steve; Towler, S.; Leahy, Michael.

In: Transfusion, Vol. 55, No. 5, 05.2015, p. 1082-1089.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Increased hospital costs associated with red blood cell transfusion

AU - Trentino, K.M.

AU - Farmer, Shannon

AU - Swain, S.G.

AU - Burrows, Sally

AU - Hofmann, Axel

AU - Ienco, R.

AU - Pavey, W.

AU - Daly, Frank

AU - Van Niekerk, A.

AU - Webb, Steve

AU - Towler, S.

AU - Leahy, Michael

PY - 2015/5

Y1 - 2015/5

N2 - Background: Red blood cell (RBC) transfusion is independently associated in a dose-dependent manner with increased intensive care unit stay, total hospital length of stay, and hospital-acquired complications. Since little is known of the cost of these transfusion-associated adverse outcomes our aim was to determine the total hospital cost associated with RBC transfusion and to assess any dose-dependent relationship. Study Design and Methods: A retrospective cohort study of all multiday acute care inpatients discharged from a five hospital health service in Western Australia between July 2011 and June 2012 was conducted. Main outcome measures were incidence of RBC transfusion and mean inpatient hospital costs. Results: Of 89,996 multiday, acute care inpatient discharges, 4805 (5.3%) were transfused at least 1 unit of RBCs. After potential confounders were adjusted for, the mean inpatient cost was 1.83 times higher in the transfused group compared with the nontransfused group (95% confidence interval, 1.78-1.89; p <0.001). The estimated total hospital-associated cost of RBC transfusion in this study was AUD $77 million (US $72 million), representing 7.8% of total hospital expenditure on acute care inpatients. There was a significant dose-dependent association between the number of RBC units transfused and increased costs after adjusting for confounders. Conclusion: RBC transfusions were independently associated with significantly higher hospital costs. The financial implication to hospital budgets will assist in prioritizing areas to reduce the rate of RBC transfusions and in implementing patient blood management programs.

AB - Background: Red blood cell (RBC) transfusion is independently associated in a dose-dependent manner with increased intensive care unit stay, total hospital length of stay, and hospital-acquired complications. Since little is known of the cost of these transfusion-associated adverse outcomes our aim was to determine the total hospital cost associated with RBC transfusion and to assess any dose-dependent relationship. Study Design and Methods: A retrospective cohort study of all multiday acute care inpatients discharged from a five hospital health service in Western Australia between July 2011 and June 2012 was conducted. Main outcome measures were incidence of RBC transfusion and mean inpatient hospital costs. Results: Of 89,996 multiday, acute care inpatient discharges, 4805 (5.3%) were transfused at least 1 unit of RBCs. After potential confounders were adjusted for, the mean inpatient cost was 1.83 times higher in the transfused group compared with the nontransfused group (95% confidence interval, 1.78-1.89; p <0.001). The estimated total hospital-associated cost of RBC transfusion in this study was AUD $77 million (US $72 million), representing 7.8% of total hospital expenditure on acute care inpatients. There was a significant dose-dependent association between the number of RBC units transfused and increased costs after adjusting for confounders. Conclusion: RBC transfusions were independently associated with significantly higher hospital costs. The financial implication to hospital budgets will assist in prioritizing areas to reduce the rate of RBC transfusions and in implementing patient blood management programs.

U2 - 10.1111/trf.12958

DO - 10.1111/trf.12958

M3 - Article

VL - 55

SP - 1082

EP - 1089

JO - Transfusion

JF - Transfusion

SN - 0041-1132

IS - 5

ER -