Arnold D M, Webert K E, Carruthers J, Almonte T, Decker K, Seroski W, Reed J, Chan A K C, Pai M, Walker I
Department of Medicine, McMaster University, Hamilton, ON, Canada.
Haemophilia. 2007 May;13(3):271-8. doi: 10.1111/j.1365-2516.2007.01452.x.
The Commission of Inquiry on the Blood System in Canada ('Krever Commission', 1997) recommended an active programme of surveillance for all blood products. To describe trends in the utilization of coagulation factor concentrates using a comprehensive factor tracking programme. Between 2001 and 2004 in the region of Southern Ontario, we prospectively tracked all coagulation factor concentrates that were distributed from the national blood supplier, issued by hospitals for inpatient use or for home infusions, infused at hospital facilities or at home and wasted. Discrepancies were reconciled by independent audits. Trends in the utilization of FVIII, FIX and FVIIa concentrates are reported. A total of 466 patients with inherited or acquired bleeding disorders were registered. Utilization of FVIII, FIX and FVIIa increased by an average of 13.7%, 33.2% and 34.2% per year respectively. Most FVIII and FIX infusions were administered at home while most FVIIa infusions were in hospital. The increase in FVIII and FIX usage was attributable to an increase in per-patient use, predominantly for prophylaxis. In total, 1.7% of coagulation factor concentrates was wasted during the study period, at a cost of over 1 million Canadian dollars. Utilization of coagulation factor concentrates increased steadily during the study period. A regional programme to track utilization is feasible and may be used to describe trends, assist planning, and reduce costs by minimizing wastage.
加拿大血液系统调查委员会（“克雷弗委员会”，1997年）建议对所有血液制品实施积极的监测计划。通过一个全面的因子追踪计划来描述凝血因子浓缩剂的使用趋势。在2001年至2004年期间，在安大略省南部地区，我们前瞻性地追踪了所有从国家血液供应商分发的凝血因子浓缩剂，这些浓缩剂由医院发放用于住院患者或家庭输注，在医院设施或家中输注以及被浪费的情况。差异通过独立审计进行核对。报告了FVIII、FIX和FVIIa浓缩剂的使用趋势。总共登记了466名患有遗传性或获得性出血性疾病的患者。FVIII、FIX和FVIIa的使用量分别平均每年增加13.7%、33.2%和34.2%。大多数FVIII和FIX输注是在家中进行的，而大多数FVIIa输注是在医院进行的。FVIII和FIX使用量的增加归因于每位患者使用量的增加，主要用于预防。在研究期间，总共1.7%的凝血因子浓缩剂被浪费，成本超过100万加元。在研究期间，凝血因子浓缩剂的使用量稳步增加。一个追踪使用情况的区域计划是可行的，可用于描述趋势、协助规划并通过尽量减少浪费来降低成本。
