The cost effectiveness of preoperative autologous blood donations.
Since the recognition that human immunodeficiency virus is transmissible by blood transfusion there has been increasing public and professional support for autologous blood donations before elective surgery.
Autologous blood donation is, however, a more expensive process than the donation of allogeneic blood by community volunteers.
Furthermore, there have been recent improvements in the safety of the volunteer blood supply.
We used a decision-analysis model to assess the cost effectiveness of donating autologous blood for four surgical procedures.
Cost data were collected from the observation of transfusion practice at the University of California, Los Angeles, in 1992.
Estimates of the risks of transfusion-associated diseases and the costs of treating them came from the medical literature.
Cost effectiveness was expressed in dollars per quality-adjusted year of life saved.
We performed sensitivity analyses of the variables in our model and examined the effect of strategies suggested to reduce costs.
Substituting autologous for allogeneic blood resulted in little expected health benefit (0.0002 to 0.00044 quality-adjusted year of life saved) at considerable additional cost ($68 to $4,783 per unit of blood).
The additional cost of autologous blood was primarily a function of the discarding of units that were donated but not transfused and of a more labor-intensive donation process.
Mots-clés Pascal : Transfusion, Autogreffe, Prélèvement, Préopératoire, Analyse coût efficacité, Homme, Hématologie, Réanimation
Mots-clés Pascal anglais : Transfusion, Autograft, Samplings, Preoperative, Cost efficiency analysis, Human, Hematology, Resuscitation
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0208920
Code Inist : 002B27D01. Création : 09/06/1995.