Date of Award

2006

Degree Type

Thesis

Degree Name

Master of Science

Program

Epidemiology and Biostatistics

Supervisor

Dr. Jeffrey Hoch

Second Advisor

Dr. Gregory Zaric

Third Advisor

Dr. JoAnne Chiavetta

Abstract

Objectives: The purpose of this research is to assess the long-term cost-effectiveness of blood conservation by incorporating both ‘known’ and ‘unknown’ blood-borne agents into an economic evaluation of blood conservation. Methods: A Markov cohort simulation is used to generate estimates of the costs and effects of blood conservation. These estimates are then compared to the costs and effects of usual care, using the incremental cost-effectiveness ratio (ICER). The resulting ratio gives an estimate of the cost and effect tradeoff of implementing such a program. Cost-effectiveness is discussed in terms of the decision makers’ willingness to pay for blood safety measures. Results: ICERs incorporating ‘unknown’ risks are substantially lower than those that only incorporate ‘known’ risks such as HIV, HCV, and HBV. Conclusions: Based on these results it would appear that ‘unknown’ risks have the potential to impact, in a measurable way, the cost-effectiveness of blood conservation.

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