Hospitals see improved outcomes, lower costs as blood transfusions drop

Hospitals across the country have been cutting back on their use of blood, saving them money and improving patient outcomes, according to a new study.

Premier, the nation's largest group purchasing organization, found that since its last analysis in 2012 blood utilization has been cut nearly in half across the 10 procedures that use the most blood without compromising quality of care. Rates of mortality, complications and readmissions fell in that same timeframe.

The GPO's nationwide analysis of 645 hospitals spanning 2011 through the first half of 2016 revealed a 20% decrease in blood utilization across 134 diagnoses that account for the vast majority of red blood cell use.

The blood use cuts helped Mercy Health save $6.2 million over that time period, said Wayne Bohenek, vice president of clinical support services at the health system.

"We are conserving a scarce resource and improving patient care," he said.

Blood transfusions are widely used in hospitals to offset blood loss during surgery and to treat conditions like anemia and blood disorders. They have been a longstanding practice, despite known complications, and are believed to improve patient outcomes. About 1 out of 10 hospitalizations are associated with blood transfusions, according to the study.

But researchers have found that blood transfusions among cardiac surgery patients have been linked to increased risk of mortality. Transfusions, of which around 40% are unnecessary according to some estimates, can increase the likelihood of allergic reactions, fever, lung injury, immune suppression, iron overload and other harmful side effects. They can also drain a hospital's finances, as each unit of red blood cells costs $218, not accounting for overhead and transportation costs that can inflate the price nearly 5 times.

"Today's healthcare providers face constant pressures to improve quality and reduce total costs. Given this reality, more providers are looking to optimize blood use, a very expensive resource that can lead to adverse events if not properly managed," Leigh Anderson, Premier's chief information officer, said in a statement.

Researchers recommended integrating tools in electronic health records that monitor blood use, standardizing ordering and utilization practices, engaging physicians to ensure standards are maintained throughout the organization and analyzing data to track trends.