Blood transfusion costs by diagnosis-related groups in 60 university hospitals in 1995

BACKGROUND: Transfusion services are frequently challenged to initiate effo rts to reduce blood transfusion costs. One approach is to analyze blood tra nsfusion costs for individual medical and surgical Diagnosis-Related Groups (DRGs). Rank ordering of DRGs by transfusion costs and interinstitutional comparisons of these costs may lead to the selection of DRGs for further an alysis of the process of blood transfusion. STUDY DESIGN AND METHODS: Common DRGs (n = 486) that were related to discha rges in 1995 were analyzed from 60 university hospital members of the Unive rsity HealthSystems Consortium (UHC). Cost data were tabulated by using cos t-to-charge ratios reflecting all aspects of blood transfusion-related cost s of participating institutions. RESULTS: Of these 486 DRGs, 471 had identifiable mean blood costs, and 34 h ad median blood costs, mostly for surgical conditions. Transfusion costs re presented a small proportion (less than or equal to1%) of total hospitaliza tion costs for most DRGs. Nonetheless, millions of dollars were spent on bl ood transfusion, and for the most expensive DRGs, the costs ranged from 5.0 to 8.6 percent of total hospitalization costs. Transfusion costs are more variable for the DRGs with the lowest transfusion costs than for those with the highest transfusion costs. CONCLUSION: Members of the UHC may utilize such analyses to identify surgic al or medical diagnoses with transfusion costs at variance with the group n orm. These DRGs could then be targeted for further evaluation of components contributing to high costs, for possible alterations in physician or clini cal laboratory practices. Considering those conditions with the highest cum ulative transfusion costs (e.g., BMT, liver transplant, acute leukemia, and cardiothoracic procedures), changes in transfusion practices that affect t hese particular patient categories may have a significant impact on global blood transfusion costs.