Today we’ll be discussing the costs associated with serologic-testing for antibody-positive patients requiring blood transfusions. In the United States, healthcare costs are soaring. By 2021, the health-care-spending to GDP ratio is estimated to be almost 20% of the economy. Costs of blood transfusions are also on the rise. Little is known, however, about the frequency of particular serologic tests and the associated costs.
Dr. Kaufman elaborates, “Everyone in transfusion medicine is very used to thinking about conserving blood products. But it’s also important to consider the utilization of other resources, such as blood bank laboratory testing. We thought it was a good idea to determine what the real costs of serological testing are today.”
Dr. Kaufman and his team collected patient demographics, transfusion and serologic history, and financial data of more than 6,000 serologic work-ups from over 3,600 patients at 4 major US hospitals to tease apart transfusion costs.
Here is Dr. Kaufman with the main results from the study: “among consecutive patients with a positive antibody screen, the mean direct cost of serological testing was $114 per work up, and $195 per patient. But we found that certain patient categories were strongly associated with far higher blood bank testing costs.”
Specifically, they found that patients with autoimmune hemolytic anemia had the highest cost of $505 per serologic work-up and also the highest cost per patient over the course of the study at $1490. Patients with hematologic malignancies, hemoglobinopathies, and those receiving transplants also had higher costs associated with serologic work-ups. Obstetric and neonatal intensive care unit patients had the lowest cost at $69 per serologic work-up.
Kaufman and colleagues also found that the costs of serologic work-ups can be substantial, especially among antibody-positive patients or those who previously received multiple transfusions.
Dr. Stubbs wrote an accompanying editorial and adds,“We are at the tip of the iceberg in assessing our costs, and we need to not only take that information about what various functions that transfusion services provide and the cost, but take that information and then convert that into analysis and action plans to maintain the same high quality of care most cost effectively and efficiently.”
We’ll be back with another edition of Transfusion News on February 28th. Thanks for joining us.
2. Mazonson P, Efrusy M, Santas C, Ziman A, Burner J, Roseff S, Vijayaraghavan A, Kaufman R: The HI-STAR study: Resource utilization and costs associated with serologic testing for antibody-positive patients at four United States medical centers. Transfusion 2014;54: 271–277.