伊朗南部新生儿重症监护病房使用成人红细胞血袋和儿童血袋的成本分析研究。
A cost-analysis study of using adult red cell packs and Pedi-Packs in newborn intensive care units in Southern Iran.
作者信息
Haghpanah Sezaneh, Miladi Shima, Zamani Ali, Abadi Ali Mohammad Keshtvarz Hesam, Gholami Marjan, Gholami Maryam
机构信息
Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Clinical Research Development Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
出版信息
Cost Eff Resour Alloc. 2021 Mar 6;19(1):15. doi: 10.1186/s12962-021-00267-7.
BACKGROUND AND OBJECTIVE
Saving blood products is an important public health issue especially in developing countries with limited financial resources. We aimed to suggest a new hypothetical model to make a change in the current blood transfusion policy in the newborn intensive care unit (NICU) to reduce wastage of blood supplies as well as the risk of exposure to multiple donors.
METHODS
In this cross-sectional study, all transfused neonates (n = 70) who were admitted to NICU of Nemazee Hospital, a tertiary referral hospital in Southern Iran, were evaluated between March and June 2019. Based on the information of neonates' transfusion during this study period and determined transfusion indices, a specific pediatric pack was suggested and the related total costs per transfusion, as well as the donor-exposure rate of the hypothetical and the current transfusion method, were compared.
RESULTS
Considering the mean number of transfusions per neonate: 4 and mean volume of transfused packed red cells: 20 ml per transfusion, the cost-analysis of pediatric and the adult pack was presented. Arithmetically, we proved a higher total cost per transfusion for using adult pack comparing to pediatric pack. Additionally, using a pediatric pack set leads to a 24% reduction in RBCs wastage per transfusion and a 68.13% reduction in donor-exposure rate.
CONCLUSIONS
The assignment of a dedicated pediatric pack for neonates will be able to improve the cost-effectiveness by a substantial reduction in donor-exposure rate and blood wastage. This finding should be taken into consideration to generate economic growth and make improvements in child health status.
背景与目的
节约血液制品是一个重要的公共卫生问题，在财政资源有限的发展中国家尤为如此。我们旨在提出一种新的假设模型，以改变新生儿重症监护病房（NICU）目前的输血政策，减少血液供应的浪费以及接触多个供血者的风险。
方法
在这项横断面研究中，2019年3月至6月期间对所有入住伊朗南部一家三级转诊医院纳马齐医院新生儿重症监护病房的输血新生儿（n = 70）进行了评估。根据本研究期间新生儿输血的信息和确定的输血指标，建议了一种特定的儿科用血包，并比较了每次输血的相关总成本以及假设输血方法和当前输血方法的供血者暴露率。
结果
考虑到每个新生儿的平均输血量为4次，每次输血的红细胞浓缩液平均输注量为20毫升，对儿科用血包和成人用血包进行了成本分析。从算术上看，我们证明与儿科用血包相比，使用成人用血包每次输血的总成本更高。此外，使用儿科用血包可使每次输血的红细胞浪费减少24%以及供血者暴露率降低68.13%。
结论
为新生儿分配专用的儿科用血包将能够通过大幅降低供血者暴露率和血液浪费来提高成本效益。这一发现应予以考虑，以促进经济增长并改善儿童健康状况。
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