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Community Blood Supply Model: Development of a New Model to Assess the Safety, Sufficiency, and Cost of the Blood Supply

Blood Systems Research Institute, 270 Masonic Avenue, San Francisco, CA 94118-4417; Pharmaceutical Outcomes Research and Policy Program, University of Washington, Seattle; Blood Systems Research Institute, San Francisco, Californiabcuster{at}bloodsystems.org

Eric S. Johnson, PhD

Sean D. Sullivan, PhD

Tom K. Hazlet, PharmD, DrPH

Scott D. Ramsey, MD, PhD

Pharmaceutical Outcomes Research and Policy Program, University of Washington, Seattle

Edward L. Murphy, MD, MPH

Michael P. Busch, MD, PhD

Blood Systems Research Institute, San Francisco, California; and University of California, San Francisco, Department of Laboratory Medicine

Background. Through a combination of predonation donor screening and donated unit testing, the blood supply is safer than ever. However, as a result of increasingly stringent screening measures, one of the greatest threats may be an insufficient supply. The balance between safety and adequacy of the blood supply has not received enough attention. Study Design and Methods. The authors developed a model to allow for empirical investigation of the determinants of a safe and sufficient supply. The model is a cohort simulation of allogeneic whole-blood donation, with the population of presenting donors stratified into 8 age and gender groups because the probability of donor and donation deferral varies by these characteristics. Parameters are estimated from year 2000 Blood Centers of Pacific (BCP) data. The model includes cost parameters, which were estimated using BCP expenditure data. The main outcomes are the number of transfusable units of blood and the unit cost of procurement. Results. The model tracks the production of a supply of blood, highlighting the influence of demographic characteristics, predonation deferral, underweight collection of blood units, and associated costs. The authors sought to establish model validity by showing that modeled results closely mimic the outcomes and costs observed by blood bank administrators. Conclusion. The model was developed to evaluate blood safety and policy decisions; it can be used to assess the impact of predonation deferrals, such as expanded European travel deferral for variant Creutzfeldt-Jakob disease, or the impact of new testing strategies, such as nucleic acid testing for West Nile virus.

Key Words: blood donors • blood banks • cohort • computer simulation • costs and cost analysis • economics

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