Abstract
The implementation of preoperative anemia measures, first pillar of the Patient Blood Management programme (PBM), is associated with improved patient outcomes, reduced rates of blood transfusions and reduction of hospital costs. The aim of this study is to estimate the clinical and economic impact of addressing iron deficiency anemia in preoperative elective surgery patients in the German health system. A well-known German healthcare database (DRG-Statistik, 2015) is used to extract and analyze data from 4.6 million elective surgery patients. We estimate the patient outcomes and the potential direct hospital cost-savings of implementing preoperative anemia measures in Germany. The analysis of the clinical characteristics (ICD-10-GM) and the Diagnostic Related Groups (DRGs) from the German database allows to identify and allocate groups of patients and their costs on the basis of two risk factors: Iron Deficiency Anemia and risk of undergoing blood transfusions. A health economics model estimates the clinical benefits (avoided deaths) and potential net cost-savings of identifying and treating a target population of preoperative iron deficiency anemia patients in the German healthcare system. The implementation of effective preoperative anemia measures, which would account for an investment of 10.4 million € in Germany, to both diagnosed and undiagnosed elective surgery iron deficiency anemia patients yields the following outcomes: 2,773 avoided hospital deaths per year; 528,531 avoided hospital days per year; and a net potential hospital direct cost-savings of 914 million € per year in Germany. This study shows that implementing preoperative anemia measures, the first pillar within the Patient Blood Management programme (PBM), represents an efficient public health intervention. In short, in the German healthcare system it would lead to the prevention of deaths and a net potential direct hospital costs-savings of 914 million € which account for 1.4% of the total hospital costs in Germany.
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