RISK-ADJUSTED ASSESSMENT OF FRESH FROZEN PLASMA AND ALBUMIN PRODUCT USE IN ACUTE-CARE HOSPITALS IN JAPAN: AN ANALYSIS USING ADMINISTRATIVE DATA

DOI 2 Citations 54 References
  • Sekimoto Miho
    Department of Healthcare Economics and Quality Management, Kyoto University School of Public Health
  • Imanaka Yuichi
    Department of Healthcare Economics and Quality Management, Kyoto University School of Public Health
  • Yoshihara Keiichi
    Department of Healthcare Economics and Quality Management, Kyoto University School of Public Health
  • Shirai Takako
    Department of Healthcare Economics and Quality Management, Kyoto University School of Public Health
  • Sasaki Hiromasa
    Department of Healthcare Economics and Quality Management, Kyoto University School of Public Health
  • Komeno Takuya
    Department of Hematology, National Hospital Organization Mito Medical Center
  • Lee Jason
    Department of Healthcare Economics and Quality Management, Kyoto University School of Public Health
  • Ashihara Eishi
    Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital
  • Maekawa Taira
    Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital

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  • ケースミックスを考慮した新鮮凍結血漿およびアルブミン製剤使用量の評価

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Inappropriate use of fresh frozen plasma (FFP) and albumin products has been a serious problem in Japan. The continuous monitoring of blood use and feedback on transfusions can effectively decrease inappropriate blood transfusions. We proposed a method to assess hospital-level use of FFP and albumin products using administrative data (DPC data).<br> First, we conducted a retrospective audit of blood utilization at two hospitals to examine the underlying conditions for blood utilization and the appropriateness of blood transfusion in each hospital. Next, using DPC data from 587,045 cases provided by 73 acute-care hospitals, we developed case-mix-adjustment models to predict hospital-wide use of albumin and FFP. In order to assess case-mix adjusted blood products use, the expected total use of albumin or FFP at the hospital was compared with the observed values, by calculating observed to expected ratios (O/E ratios) for each hospital. The assessment by O/E ratio was compared with the proportion of appropriate blood products use.<br> The proportions of appropriate use of FFP and albumin were quite low (range from 20% to 30%). Model goodness-of-fit assessed using R2 for linear regression was 0.77 for albumin use, and 0.78 for FFP use. High O/E ratios calculated using the case-mix adjustment models tended to be relative to low proportions of appropriate transfusions. It was suggested that DPC data can be used for the evaluation of appropriate blood use.<br>

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