2009 Volume 55 Issue 6 Pages 717-722
A comprehensive questionnaire on transfusion medicine was performed for 4 consecutive years, from 2004 to 2007, to evaluate the establishment of an adequate transfusion management system and activities of Hospital Transfusion Committees. A unified management system for blood products as well as the centralized performance of transfusion tests was present in 748 hospitals (88.7%). Adequate control of albumin products was observed in 621 institutions (75%). This finding is attributable to the transfusion management fee, approved by the Ministry of Health, Labor and Welfare of Japan in 2005, on the basis that control of the usage of albumin products is one of the conditions to obtain the transfusion management fee. Hospital Transfusion Committees were established in 799 institutions (95.2%), and the number of hospitals with full-time or part-time transfusionists as well as laboratory technologists responsible for transfusion increased gradually from 2004 to 2007. However, a substantial discrepancy was seen in the rate of hospitals with a 24-hour system for transfusion tests between those with more than 300 beds (90.9%), and those with less than 300 beds (44.4%). Introduction of a computer system for transfusion gradually increased, but it is still too low, with only 55.5% of the hospitals with less than 300 beds using such systems. More than 1/3 of responding hospitals had already met the conditions required to get the transfusion management fee (type I: 133 institutions, type II: 188 institutions). Analyzing the usage and wastage rates of blood products per number of beds, according to the presence or absence of full-time transfusionists, hospitals with transfusionists had a higher usage rate but lower wastage rate than hospitals without transfusionists, and the difference was more evident among hospitals with more than 300 beds. Moreover, among the hospitals with more than 300 beds in which only part-time transfusionists were present, the wastage rate was lower in those where laboratory technologists responsible for transfusion were present.
