Red Cell Usage

The use of red blood cell products has been shown to be highly variable, with some patients receiving transfusions that are not required. The States and Territories have safety and quality programs aimed at improving the rate of clinically appropriate transfusions, but these programs often have limited access to data on blood use drivers and trends.

The purpose of the NBA’s National Data Linkage Project is to facilitate jurisdictional-based data linkage with the aim of producing a nationally consistent dataset of, and ultimately a national report on, blood product use in Australia.

The diagram below illustrates how data linkages will be implemented (click on image to enlarge).

Diagram showing how data linkages between activity based, blood product, and pathology datasets can be linked and analysed to provide a national dataset - view larger image

Questions to be answered

The project is focused on providing data to answer key questions, as explained in the table below. 

Questions to be answered

Analysis Area

Key Questions

Broad Indicators

Pattern of Transfusion by Specialty Groups (broad ‘data screening’ step for overall trends and drivers)

Which specialty areas are key users of blood and blood products?

Overall volumes

Admissions with/without transfusion (no & %)

Average units/volume per patient (transfused and all patients)

Single unit transfusion rates

How have blood use trends changed over time? 
-  by specialty and by hospital?
-  by day and overnight patients?
-  by emergency and elective patients?
-  by medical and surgical patients?
-  by age and gender of patients?

How do hospitals compare with blood use overall and by specialty?

Specialty Group Targeted Analysis (more detailed regular analysis following from initial data screening above)

Which conditions/diagnoses/procedures are key users of blood and blood products within the target specialty (Diagnosis-related group (DRG), International classification of diseases (ICD) codes)? (Clinician engagement to identify appropriate clinical groupings is essential)

How do hospitals compare with blood use by the relevant clinical sub-groupings?

Supporting Clinical Practice Improvement Initiatives (more specific and tailored analysis)

Does the data show potential diversion from nationally endorsed clinical guidelines for transfusion?

The NBA held a workshop in March 2013 to progress this project on red cell data usage. The outcomes of the workshop will be provided to governments.