A cost-effectiveness analysis of the use of a mechanical barrier system to reduce the risk of mistransfusion

Background: A blood component is transfused to a patient other than the intended recipient because of patient and sample identification problems once in about every 24,000 transfusions. An investigation was performed of the cost-effectiveness of a barrier system to prevent mistransfusion of a unit of red cells through this kind of error. Study Design and Methods: A decision analysis model was constructed that took into account nonfatal and fatal events, costs of patient care, and legal costs. The model was used to determine the cost-effectiveness of the barrier system in terms of cost per year of life saved and lives saved per million transfusions. Results: The barrier system is predicted to save 1.5 lives per million transfusions when used as intended. If the cost-effectiveness calculations are based on an average damage award for a fatality of more than $725,000 and a chance of mistransfusion exceeding 1 in 16,700, use of;the system results in reduced healthcare expenditures. If no legal costs are included in the cost-effectiveness calculations, use of the system costs $197,000 per year of life saved. Routine use of the system extends patient life by 1 year per 60,000 units transfused. Conclusion: The application of a barrier system to prevent mistransfusion and related morbidity and mortality can be cost-effective. If legal costs are included in the calculations, the use of a barrier system reduces total costs.