COSTS OF BLOOD-TRANSFUSION - A PROCESS-FLOW ANALYSIS

Purpose: To determine the cost of transfusing 2 units (U) of packed RB Cs at a comprehensive cancer center. Methods: We performed a process-f low analysis to identify all costs of transfusing 2 U of allogeneic pa cked RBCs on an outpatient basis to patients with either (1) solid tum or who did not undergo bone marrow transplantation (BMT), (2) solid tu mor who underwent BMT, (3) hematologic malignancy who did not undergo BMT, (4) hematologic malignancy who underwent allogeneic BMT, or (5) h ematologic malignancy who underwent autologous BMT. We conducted struc tured interviews ta determine the personnel time used and physical res ources necessary at all steps of the transfusion process. Results: The mean cost of a 2-U transfusion of allogeneic packed RBCs was $548, $5 65, $569, $569, and $566 for patients with non-BMT solid tumor, BMT so lid tumor, non-BMT hematologic malignancy allogeneic BMT hematologic m alignancy, and autologous BMT hematologic malignancy respectively. Sen sitivity analysis showed that total transfusion costs were sensitive t o variations in the amount of clinician compensation and overhead cost s, but were relatively insensitive to reasonable variations in the dir ect costs of blood tests and the blood itself, or the probability or e xtent of transfusion reaction. Conclusion: The costs of the transfusio n of packed RBCs are greater than previously analyzed, particularly in the cancer care setting. (C) 1998 by American Society of Clinical Onc ology.