A comparison of public and private hospital on rational use of blood in Islamabad.

OBJECTIVE To assess rational use of blood and blood products in adults treated in surgical and allied departments in a public and a private hospital in Islamabad. METHODS The comparative cross-sectional study was conducted from April 15 to June 15, 2011, in Islamabad. A total of 350 patients were enrolled using universal sampling; 170 (48%) from the public and 180 (52%) from the private hospital. Data was collected using a pre-tested questionnaire on age, gender, department, haemoglobin levels, indications of blood transfusions, types of product advised, total number of units ordered, cross-matched and transfused. Rational use of blood was assessed by determining prevalence of appropriateness using World Health Organisation's clinical practical guidelines and transfusion indices.Ten in-depth interviews were done with doctors to assess their knowledge and practices. SPSS 15 was used for statistical analysis. RESULT In the public hospital, appropriate use of blood was only 54.1% (n = 92) as compared to the private hospital where the appropriateness was 69.4% (n = 125). The cross-matched-to-transfusion ratio was 1.1 and 2.7, where transfusion index was 2.6 and 2.5 in public and private hospital respectively. Doctors had good clinical knowledge, but were not using any guidelines. CONCLUSION Neither the public nor the private hospital was rational in use of blood.