卢旺达无人机（无人机）投递对血液制品投递时间和浪费的影响：回顾性、横断面研究和时间序列分析。
Effect of unmanned aerial vehicle (drone) delivery on blood product delivery time and wastage in Rwanda: a retrospective, cross-sectional study and time series analysis.
机构信息
Centre for Health Services and Policy Research, The University of British Columbia, Vancouver, BC, Canada; School of Population and Public Health, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada.
Rwanda Biomedical Centre, Kigali, Rwanda; African Institute for Mathematical Sciences, Kigali, Rwanda; The Laboratory of Emerging and Infectious Diseases, Department of Microbiology and Immunology, Faculty of Medicine, Canadian Center for Vaccinology, Dalhousie University, Halifax, NS, Canada.
出版信息
Lancet Glob Health. 2022 Apr;10(4):e564-e569. doi: 10.1016/S2214-109X(22)00048-1.
BACKGROUND
The accessibility of blood and blood products remains challenging in many countries because of the complex supply chain of short lifetime products, timely access, and demand fluctuation at the hospital level. In an effort to improve availability and delivery times, Rwanda launched the use of drones to deliver blood products to remote health facilities. We evaluated the effect of this intervention on blood product delivery times and wastage.
METHODS
We studied data from 20 health facilities between Jan 1, 2015, and Dec 31, 2019, in Rwanda. First, we did a cross-sectional comparison of data on emergency delivery times from the drone operator collected between March 17, 2017, and Dec 31, 2019, with two sources of estimated driving times (Regional Centre for Blood Transfusion estimates and Google Maps). Second, we used interrupted time series analysis and monthly administrative data to assess changes in blood product expirations after the commencement of drone deliveries.
FINDINGS
Between March 17, 2017, and Dec 31, 2019, 12 733 blood product orders were delivered by drones. 5517 (43%) of 12 733 were emergency orders. The mean drone delivery time was 49·6 min (95% CI 49·1 to 50·2), which was 79 min faster than existing road delivery methods based on estimated driving times (p<0·0001) and 98 min faster based on Google Maps estimates (p<0·0001). The decrease in mean delivery time ranged from 3 min to 211 min depending on the distance to the facility and road quality. We also found a decrease of 7·1 blood unit expirations per month after the start of drone delivery (95% CI -11·8 to -2·4), which translated to a 67% reduction at 12 months.
INTERPRETATION
We found that drone delivery led to faster delivery times and less blood component wastage in health facilities. Future studies should investigate if these improvements are cost-effective, and whether drone delivery might be effective for other pharmaceutical and health supplies that cannot be easily stored at remote facilities.
FUNDING
Canadian Institutes for Health Research.
背景
由于短寿命产品的供应链复杂、及时获取以及医院层面的需求波动，许多国家的血液和血液制品的供应仍然具有挑战性。为了提高可用性和交付时间，卢旺达推出了使用无人机向偏远医疗设施运送血液制品。我们评估了这种干预措施对血液制品交付时间和浪费的影响。
方法
我们研究了 2015 年 1 月 1 日至 2019 年 12 月 31 日期间卢旺达 20 个卫生设施的数据。首先，我们对 2017 年 3 月 17 日至 2019 年 12 月 31 日期间无人机操作员收集的紧急交货时间数据与两种估计驾驶时间来源（区域血液中心估计数和谷歌地图）进行了横截面比较。其次，我们使用中断时间序列分析和每月行政数据评估了无人机交付后血液制品过期情况的变化。
结果
2017 年 3 月 17 日至 2019 年 12 月 31 日期间，通过无人机交付了 12733 份血液制品订单。其中 5517 份（43%）为紧急订单。无人机的平均交付时间为 49.6 分钟（95%CI 49.1-50.2），比现有基于估计行驶时间的公路运输方式快 79 分钟（p<0.0001），比基于谷歌地图的估计快 98 分钟（p<0.0001）。平均交付时间的减少范围为 3 分钟至 211 分钟，具体取决于到设施的距离和道路质量。我们还发现，在开始使用无人机交付后，每月的血液制品过期数量减少了 7.1 个单位（95%CI-11.8 至-2.4），12 个月后减少了 67%。
结论
我们发现，无人机交付使卫生设施的交货时间更快，血液成分浪费更少。未来的研究应调查这些改进是否具有成本效益，以及无人机交付是否可能对其他不能在偏远设施中轻易储存的药物和医疗用品有效。
资助
加拿大卫生研究院。
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