Comparative Cost Analysis of Using Pedi-packs and Adult Red Cell Packs in Newborn Intensive Care Units in Southern Iran

Abstract

Background and objective:In most developing countries, blood transfusions are routinely administered by adult red blood cells (RBCs) packs in infants leading to wastage of a large amount of blood supplies as well as having high donor exposure risk. We aimed to compare the cost-effectiveness of hypothetical pediatric pack compared to adult RBCs pack in neonates.Methods: In this cross-sectional study, all transfused neonates (n = 70) who were admitted to the newborn intensive care unit (NICU) of Nemazee Hospital, a tertiary referral hospital in Shiraz, Southern Iran, were evaluated between March and June, 2019. Based on the blood bank information during the study period and transfusion indices, a specific pediatric pack was suggested and cost-effectiveness of new and traditional transfusion methods was compared.Results: Considering the mean number of transfusions per neonate: 3.57 and mean volume of transfused packed red cells: 20 ml per transfusion during the study period; a quadruple pediatric pack (240 ml divided in 4 sub-packs) was purposed and cost-analysis of pediatric and adult pack was performed. Mathematically, we proved higher cost-effectiveness in using pediatric versus adult pack. Additionally, using pediatric packs leads to 13.74% reduction in RBCs wastage per transfusion and 68.13% reduction in donor exposure rate.Conclusions: Assignment of dedicated pediatric pack for infants will be able to substantially reduce donor exposure risk as well as wasted resources leading to higher cost effectiveness. This finding should be taken into consideration especially in developing countries in order to promote both economic situation and child health status.