Blood management in the Netherlands - Methods, results and costs

The Dutch health care system introduced a simple and efficacious blood management. Among European countries, the Netherlands has the lowest frequency of allogeneic blood transfusions. Dutch blood management comprises from acceptance of a low transfusion trigger, the treatment of anaemia before elective surgery and use of autologous retransfusion. The simple concept is applied to a fairly high volume of orthopedic surgery. Meanwhile, it is certified as a quality management concept and gets an external audit every year. The success of the Dutch blood management is the reduced mortality and the decreased infection rate. Furthermore, it is cost-efficient by direct savings of 100 million (sic) a year. The critical elements - such as the consensus between medical societies about the resulting improved patient care, the cost-efficiency and the limitation to only a few blood sparing techniques responsable for the blood management's prosperousness might be worth to consider in Germany.