PHP110 - SUBSTANTIAL HEALTH GAINS FROM HEATH-SYSTEM-WIDE PATIENT BLOOD MANAGEMENT IMPLEMENTATION: ANALYTICS FOR EUROPE

Abstract

The European Commission has recently published a new guidance to national health authorities and hospitals recommending the implementation of patient blood management (PBM) programs as the new standard of care across European health systems. This research aimed to estimate the potential impact of implementing nationwide PBM programs in 26 different European countries. A mathematical simulation model designated “EU PBM Analytics Tool” was developed based on post-hoc modelling of the relationship between the use of red blood cell (RBC) and its impact on key clinical outcomes (in-hospital mortality, acute myocardial infarctions (AMI)-strokes, hospital length of stay (LOS), 28-day readmissions and hospital acquired infections (HAI)), over a 5-year period, as reported by the Western-Australia PBM program. Data inputs for each country, including RBC use for transfusion, were retrieved from open sources. Results are presented in terms of in-hospital mortality, AMI-strokes, LOS (including re-admissions), HAI, and disability-adjusted life-years (DALY). Across the European countries considered, health-system-wide PBM programs could lower the average annual population-level RBC use rates from 37.9 to 26.1 units per 1,000 inhabitants (avoiding 5.6 million RBC transfusions). For an estimated 125 million emergency or high-complexity elective hospital admissions, over the time period, PBM programs could lead to avoiding 503,552 in-hospital deaths, 128,176 AMI-strokes, reduction of 46 million hospital days and 790,801 HAI. The public health impact can also accumulate to 15 million DALY, avoided on the long-run. The top 5 countries in terms of premature mortality avoidance are: Italy, the United Kingdom, France, Germany and Spain. All together accounting for more than 60% of the PBM implementation benefit, irrespective of the outcome. Implementation of a health-system-wide PBM program in Europe could be associated with unprecedented patient, hospital and public health benefits, antecipating substantial savings to society.