RT Journal Article
SR Electronic
T1 Laboratory costs of a hospital-based blood transfusion service in Malawi
JF Journal of Clinical Pathology
JO J Clin Pathol
FD BMJ Publishing Group Ltd and Association of Clinical Pathologists
SP 1117
OP 1120
DO 10.1136/jcp.2006.042309
VO 60
IS 10
A1 Antonieta Medina Lara
A1 James Kandulu
A1 Laphiod Chisuwo
A1 Andrew Kashoti
A1 Catherine Mundy
A1 Imelda Bates
YR 2007
UL http://jcp.bmj.com/content/60/10/1117.abstract
AB Background: Despite policies advocating centralised transfusion services based on voluntary donors, the hospital-based replacement donor system is widespread in sub-Saharan Africa. Aims: To evaluate the cost of all laboratory resources needed to provide a unit of safe blood in rural Malawi using the family replacement donor system Methods: Full economic costs of all laboratory tests used to screen potential donors and to perform cross-matching were documented in a prospective, observational study in Ntcheu district hospital laboratory. Results: 1729 potential donors were screened and 11 008 tests were performed to ensure that 1104 units of safe blood were available for transfusion. The annual cost of all transfusion-related tests (in 2005 US$) was $17 976, equivalent to $16.28 per unit of transfusion-ready blood. Transfusion-related tests used 53% of the laboratory’s total annual expenditure of $33 608. Conclusions: This is the first study to provide prospective economic costs of all laboratory tests associated with the family replacement donor system in a district hospital in Africa. Results show that despite potential economies of scale, a unit of blood from the centralised system costs about three times as much as one from the hospital-based “replacement” system. Factors affecting these relative costs are complex but are in part due to the cost of donor recruitment in centralised systems. In the replacement system the cost of donor recruitment is entirely borne by families of patients needing a blood transfusion.