OBJECTIVES: This study aims to provide the first estimates of the costs and effects of the large scale introduction of autologous transfusion technologies into the United Kingdom National Health Service. METHODS: A model was constructed to allow disparate data sources to be combined to produce estimates of the scale, costs, and effects of introducing four interventions. The interventions considered were preparing patients for surgery (PPS) clinics, preoperative autologous donation (PAD), intraoperative cell salvage (ICS), and postoperative cell salvage (PoCS). RESULTS: The key determinants of cost per operation are the anticipated level of reductions in blood use, the mean level of blood use, mean length of stay, and the cost of the technology. The results show the potential for considerable reductions in blood use. The greatest reductions are anticipated to be through the use of PPS and ICS. Vascular surgery, transplant surgery, and cardiothoracic surgery appear to be the specialties that will benefit most from the technologies. CONCLUSIONS: Several simplifications were used in the production of these estimates; consequently, caution should be used in their interpretation and use. Despite the drawbacks in the methods used in the study, the model shows the scale of the issue, the importance of gathering better data, and the form that data must take. Such preliminary modeling exercises are essential for rational policy development and to direct future research and discussion among stakeholders.
OBJECTIVES: This study aims to provide the first estimates of the costs and effects of the large scale introduction of autologous transfusion technologies into the United Kingdom National Health Service. METHODS: A model was constructed to allow disparate data sources to be combined to produce estimates of the scale, costs, and effects of introducing four interventions. The interventions considered were preparing patients for surgery (PPS) clinics, preoperative autologous donation (PAD), intraoperative cell salvage (ICS), and postoperative cell salvage (PoCS). RESULTS: The key determinants of cost per operation are the anticipated level of reductions in blood use, the mean level of blood use, mean length of stay, and the cost of the technology. The results show the potential for considerable reductions in blood use. The greatest reductions are anticipated to be through the use of PPS and ICS. Vascular surgery, transplant surgery, and cardiothoracic surgery appear to be the specialties that will benefit most from the technologies. CONCLUSIONS: Several simplifications were used in the production of these estimates; consequently, caution should be used in their interpretation and use. Despite the drawbacks in the methods used in the study, the model shows the scale of the issue, the importance of gathering better data, and the form that data must take. Such preliminary modeling exercises are essential for rational policy development and to direct future research and discussion among stakeholders.
Authors: Carol McLoughlin; Tracy E Roberts; Louise J Jackson; Philip Moore; Matthew Wilson; Richard Hooper; Shubha Allard; Ian Wrench; Lee Beresford; James Geoghegan; Jane Daniels; Sue Catling; Vicki A Clark; Paul Ayuk; Stephen Robson; Fang Gao-Smith; Matthew Hogg; Doris Lanz; Julie Dodds; Khalid S Khan Journal: BMJ Open Date: 2019-02-19 Impact factor: 2.692
Authors: Zia Sadique; Sarah Willis; Kaat De Corte; Mark Pennington; Carmel Moore; Stephen Kaptoge; Emanuele Di Angelantonio; Gail Miflin; David J Roberts; Richard Grieve Journal: PLoS One Date: 2022-08-17 Impact factor: 3.752
Authors: S Willis; K De Corte; J A Cairns; M Zia Sadique; N Hawkins; M Pennington; G Cho; D J Roberts; G Miflin; R Grieve Journal: Transfus Med Date: 2018-05-16 Impact factor: 2.019