Fast forward to improved patient outcomes and reduced hospital costs

PBM has the potential to improve global health by managing and preserving a patient’s own blood. When fully implemented, PBM has been shown to provide benefits for both patients and healthcare systems.1

As a result, the World Health Organization (WHO) has called for its urgent implementation as a standard of care.1 PBM is also supported by the European Commission2 and is reflected in national and international guidelines and recommendations.3–8

EVIDENCE
Real-world studies add to the weight of evidence for PBM9–12 PBM has been shown to be associated with:
Hospital stay
Reduced lengthS of hospital stay9,10
  • Median length of stay was reduced from 10 days to 8 days (p<0.001) over a 6-year study in a US cardiac surgery centre*9   
     
  • A 15% reduction in mean length of stay, after adjusting for confounders, was seen over a 6-year period in 4 major Australian hospitals†10
Transfusions
Reduced RBC transfusions10–12
  • Number of RBC units transfused per 1,000 patients decreased by 19.8%,‡11 40%§12 and 41%†10 in three different studies over 3.5- to 6-year periods
Healthcare costs
Reduced healthcare costs10–12
  • USD 78–97 M saved in activity-based transfusion costs following a 5-year health-system-wide PBM implementation in Australia¶10 
     
  • USD 12.44 M saved in blood-acquisition costs over 4 years at a Swiss hospital¶12 
     
  • USD 2.1 M saved in blood-acquisition costs per year across 5 US hospitals, calculated in the third year of the study¶11

Data from individual studies cannot be directly compared due to differences in methodologies. Please see the study designs in the footnotes below and consult the full publications for further details.

WHO POLICY BRIEF

The world Health OrganiZation (who) calls FOR the urgent need to fast forward the implementation of PBM1

 
FIND OUT MORE
Learn more about PBM and how to implement it in your hospital:
VIEW PBM WEBINARS
CSL VIFOR is committed to helping hospitals implement PBM

CSL Vifor is a global leader in iron deficiency and anaemia management; a key component in PBM. For more than a decade we have partnered with international societies and hospitals to speed up the implementation of PBM across the world.

Footnotes and abbreviations

*A retrospective analysis (N=2,662) of two time periods in the database of the Cardiac Surgery Department of Eastern Maine Medical Center for all cardiac operations and a dedicated database developed for the PBM programme [pre-PBM (July 2006–March 2007) and PBM (April 2007–September 2012)].9

†A retrospective, observational study of emergency and elective acute care adult inpatients admitted to four major tertiary‐care centres in Western Australia between 2008 and 2014 (N=605,046) to assess the impact of the PBM programme on key outcome measures.10

‡An implementation study of PBM across the five major John Hopkins hospitals. Physician-led, this was a multidisciplinary, collaborative and quality-improvement team effort to reduce transfusion overuse. The number of patients included in this report was based on available data and no a priori power calculation was conducted. All measured outcomes of interest were assessed at monthly intervals. Blood and cost savings were calculated by comparing the most recent year (2017) to the baseline (2014).11

§A retrospective impact study (N=213,882: 66,659 baseline period, 35,309 post-implementation period, and 111,914 sustainability period) assessing the implementation of a hospital‐wide PBM monitoring and feedback programme at University Hospital of Zurich, from January 2012 to December 2017.12

Cost-saving calculations are based on specific parameters dictated by individual healthcare systems and facilities.10–12

||A gross savings estimation, when blood product cost and hospital costs of administering a transfusion are combined.10

PBM, Patient Blood Management; RBC, red blood cell; USD, United States dollar; WHO, World Health Organization.

References
  1. World Health Organization. The urgent need to implement patient blood management: policy brief. 2021. Available from: https://apps.who.int/iris/handle/10665/346655 (last accessed November 2024).
  2. European Commission. Building national programs of Patient Blood Management (PBM) in the EU. A Guide for Health Authorities. March 2017. Available from: https://op.europa.eu/en/publication-detail/-/publication/5ec54745-1a8c-11e7-808e-01aa75ed71a1/language-en (last accessed November 2024).
  3. Tibi P et al. Ann Thorac Surg. 2021;112:981–1004.
  4. Vaglio S et al. Blood Transfus. 2017;15:325–8.
  5. National Blood Transfusion Committee. Patient Blood Management. An evidence-based approach to patient care. June 2014. Available from: https://www.infectedbloodinquiry.org.uk/evidence/witn7001027-patient-blood-management-26-jun-2014 (last accessed November 2024).
  6. National Blood Authority Australia. National Patient Blood Management Implementation Strategy 2017–2024. June 2017. Available from: https://www.blood.gov.au/national-patient-blood-management-implementation-strategy-2017-2024 (last accessed November 2024).
  7. Halvorsen S et al. Eur Heart J. 2022;43(39):3826–924. 
  8. Kietaibl S et al. Eur J Anaesthesiol. 2023;40(4):226–304.
  9. Gross I et al. Transfusion. 2015;55(5):1075–81.
  10. Leahy MF et al. Transfusion. 2017;57(6):1347–58.
  11. Frank SM et al. Anesthesiology. 2017;127:754–64.
  12. Kaserer A et al. Anaesthesia. 2019;74:1534–41.
  13. Vos T et al. Lancet. 2016;388:1545–602.
  14. Vos T et al. Lancet. 2017;390:1211–59.
  15. Kassebaum NJ et al. Hematol Oncol Clin North Am. 2016;30:247–308.
  16. Muñoz M et al. Br J Anaesth. 2015;115:15–24.
  17. Fowler AJ et al. Br J Surg. 2015;102:1314–24.
  18. Klein AA et al. Anaesthesia. 2016;71:627–35.
  19. Strauss WE et al. Patient Relat Outcome Meas. 2018;9:285–98.
  20. Anand IS et al. Circulation. 2018;138:80–98.
  21. Weber CF et al. Anesthesiology. 2012;117:531–47.
  22. Bolcato M et al. Transfus Apher Sci. 2020:102779.