A cost analysis of public cord blood banks belonging to the Italian cord blood network

Background: Public cord blood banking is currently managed in Italy by a network of 19 regional cord blood banks coordinated by the National Blood Centre and the National Transplant Centre. A cost analysis was carried out within the Italian network to determine the relationship between cost of cord blood collection and banking and size of the bank inventory, which ranged from 106 to 9,341 units on December 31st, 2012. Materials and methods: The 19 banks were invited to report costs incurred in 2012 related to cord blood unit collection, transportation, biological validation, characterisation, manipulation, cryopreservation, storage, data management, and general costs. Missing information on selected items was replaced with standardised costs represented by average data obtained from the reporting banks. Eight banks (52%) participated in the study. Average costs were determined in the three banks with inventories of >3,000 units vs the three banks with inventories of <1,000 units. Results: Both cord blood collection and cord blood banking costs per unit were lower in the larger banks than in the smaller banks (average collection costs: £ 119.25 and £ 151.31, respectively; average banking costs: £ 3,614.15 and £ 8,158.37, respectively). Discussion: The study outlined an inverse relationship between the costs of cord blood collection and banking and the size of the bank inventory, suggesting that scale economies could be obtained through centralisation of banking activities

A web-based clinical record 'xl'Emofilia' for outpatients with haemophilia and allied disorders in the Region of Emilia-Romagna: features and pilot use.

The treatment of haemophilia in developed countries is based on home self-infusion of concentrates. Improving communication between haemophilia centres (HC) and patients is very important. The Hub Centre (Parma) designed a new outpatient clinical record, 'xl'Emofilia', as part of a project 'Web Connections of the Region's HC' funded by Emilia-Romagna Health Authority. It is a web-based application suited to the needs of HC, which shares the databases of the region's HC, integrated with regional and national registries that can be accessed from anywhere. Data are managed with the 'https' protocol. Significant innovations are 'pathways' that help with the entry of data and 'problem list', which is a summary (updated automatically) of the patient's clinically significant data that can be consulted at a glance. With a 'web identity' (a personal USB key for secure web access), patients can record bleeds and home infusions, consult their own data and allow access to their general practitioners or in emergency departments anywhere in the world (also in English language). In December 2006, the HC started to use 'xl'Emofilia' and 673 clinical records are now active. Since April 2007, 50 pilot patients have been trained and are successfully using the system. A questionnaire administered to these patients on their level of satisfaction with the system and its ease of use gave excellent results. Our web-based system facilitates communication between patients and HC, improves the quality of care and enables patients to use these information at any time and from anywhere in the world