Journal of Clinical Oncology, Vol 16, 2364-2370, Copyright © 1998 by American Society of Clinical Oncology
Costs of blood transfusion: a process-flow analysis
SB Cantor, DV Hudson Jr, B Lichtiger and EB Rubenstein
Department of Medical Specialties, Ambulatory and Supportive Care Oncology Research Program, University of Texas M.D. Anderson Cancer Center, Houston 77030-4095, USA. sbcantor@mdanderson.org
PURPOSE: To determine the cost of transfusing 2 units (U) of packed RBCs at
a comprehensive cancer center. METHODS: We performed a process- flow
analysis to identify all costs of transfusing 2 U of allogeneic packed RBCs
on an outpatient basis to patients with either (1) solid tumor who did not
undergo bone marrow transplantation (BMT), (2) solid tumor who underwent
BMT, (3) hematologic malignancy who did not undergo BMT, (4) hematologic
malignancy who underwent allogeneic BMT, or (5) hematologic malignancy who
underwent autologous BMT. We conducted structured interviews to determine
the personnel time used and physical resources necessary at all steps of
the transfusion process. RESULTS: The mean cost of a 2-U transfusion of
allogeneic packed RBCs was $548, $565, $569, $569, and $566 for patients
with non-BMT solid tumor, BMT solid tumor, non-BMT hematologic malignancy,
allogeneic BMT hematologic malignancy, and autologous BMT hematologic
malignancy, respectively. Sensitivity analysis showed that total
transfusion costs were sensitive to variations in the amount of clinician
compensation and overhead costs, but were relatively insensitive to
reasonable variations in the direct costs of blood tests and the blood
itself, or the probability or extent of transfusion reaction. CONCLUSION:
The costs of the transfusion of packed RBCs are greater than previously
analyzed, particularly in the cancer care setting.
