OBJECTIVES

Donated blood is a critical resource in the management of cardiovascular surgery. Evidence suggests a reverse correlation between allogeneic blood transfusion (ABT) and patient health outcomes.

It is therefore important to consider blood conservation strategies, such as an autotransfusion system (ATS) where a patient’s salvaged blood is re-transfused using specialised equipment to reduce or avoid ABT and the associated risks/costs.

This research was undertaken to estimate the budget impact (BI) of instituting ATS to augment the use and dependency on ABT during cardiovascular surgery in the Kingdom of Saudi Arabia (KSA).

METHODS

A BI model was developed in MS Excel^® to compare three scenarios: i) conventional ABT (control); ii) using ATS solely; iii) using ATS and ABT.

A hospital buyer perspective was taken based on one ATS machine linked to the annual surgeries. BI was considered as the relevant direct healthcare costs incurred: blood acquisition, hospitalisation/clinical staff, follow-up, and reoperations/complications.

RESULTS

In the control group, the cost of performing a single case equated to 237,864.00 Saudi Riyal (SAR) for a hospital with in-house blood bank and SAR 238,718.00 for a hospital that procures externally. Compared to this, when using ATS solely, the cost became SAR 191,728.00 (80.6% vs control) and ATS with ABT SAR 197,405.00 (83.0% vs control) for a hospital with in-house blood bank and SAR 197,661.00 (82.8% vs control) for a hospital that procures externally. Results are driven by a substantial reduction in need for ABT, shorter length of stay and fewer reoperations/complications associated with ATS. ATS is associated with capital expenditure and the disposables used.

CONCLUSIONS

The study indicates that the implementation of ATS can be cost saving compared to conventional ABT in KSA. In this era of patient blood management, where multimodal methods of reducing dependence on ABT are commonplace, ATS appears as a valuable tool.