Priest says this saving was achieved largely because surgeons were less likely to transfuse certain low-risk patients than they were before. But additionally, more patients were transfused with less blood.
"The surgeons became more comfortable that they could safely transfuse patients to a lower level (of hemoglobin or hematocrit) than they once were," Priest says.
By Premier's analysis, administering blood transfusions is the single most commonly billed procedure hospitals provide, with 15 million blood product transfusions each year, at a cost of $10 billion to $15 billion.
Part of the reason for such wide variation is the lack of universally agreed guidelines for when surgeons should transfuse. Different professional organizations recommend different protocols, and policies differ on the use of presurgical erythropoietin, a drug that can stimulate the growth of red blood cells in hope of avoiding the need for a transfusion.