N. S. Kumar1,2, T. Wurdeman1,3, A. Gerk1, J. Bistre-Varon4, A. Ramos-De La Medina5, F. Vega-Rivera6, T. Dey1, S. Juran1,7, T. Uribe-Leitz1,8, N. Raykar1,9 1Harvard School Of Medicine, Program In Global Surgery And Social Change, Boston, MA, USA 2University Of California – San Francisco, Department Of Surgery, East Bay, Oakland, CA, USA 3Loma Linda University School Of Medicine, Department Of Surgery, Loma LInda, CA, USA 4Dorrington Medical Associates, Research, Houston, TX, USA 5Hospital Español de Veracruz, Department Of Surgery, Veracruz, VERACRUZ, Mexico 6Hospital Angeles Lomas, Universidad Autónoma de Mexico, Department Of Surgery, Mexico City, MEXICO, Mexico 7Technical University of Munich, Epidemiology, Department Of Sport And Health Sciences, Munich, MUNICH, Germany 8Children’s Hospital Boston, Department Of Plastic Surgery, Boston, MA, USA 9Brigham And Women’s Hospital, Center For Surgery And Public Health, Department Of Surgery, Boston, MA, USA
Introduction:
Blood transfusion is a basic element for emergency management, especially in surgery, and while there is an estimated 114 million unit blood deficit globally, population-level blood availability is poorly understood. To date, there have been few studies that look at the availability of blood within Mexico. This study aims to quantify blood availability and map access in Mexico.
Methods:
Using an open-source database, we conducted nationwide retrospective analysis of blood transfusion procedures performed in Mexican Ministry of Health (MOH) hospitals from 2017-2022. Transfusions were defined by ICD-9 codes 9900-9907 and calculated by transfusions per 1000 people, based on 2020 census data. Primary diagnoses were classified by alphabetic index. We used Redivis to identify population coverage within 30 and 60 minutes to hospitals that perform transfusions.
Results:
From 2017-2022, an average of 60,880 transfusions were performed per year throughout Mexico. The most common diagnoses associated with transfusions were obstetric (85,107, 23.3%), followed by gastrointestinal (48,794, 13.4%), and hematologic malignancy (46,873, 12.8%). Surgical and obstetric diagnoses comprised 58% of all transfusions in MOH hospitals. Unspecified serum and whole blood transfusions made up 83.5% (15,3306±7342, 42% and 151,567±2577, 41.5%, respectively) of total transfusions over the 6 years of study. Nationally, there were 2.90 transfusions per 1000 people, with the most populous regions having the fewest transfusions per population. 73.5% (92,620,308) of the Mexican population lives within a 30-minute catchment area of hospitals that perform transfusions and 89% (112,152,581) within 60 minutes, leaving 33.3 million and 13.8 million people outside of these 30- and 60-minute catchment areas, respectively (Figure 1).
Conclusion:
Surgical and obstetric diagnoses consisted of more than half of all transfusion requirements within the Mexican public hospital system from 2017-2022. Previously estimated blood need in Mexico is 34 units/1000 people, but a transfusion rate of 2.9 nationally and as little as 1.8 in some regions, highlights the inadequate supply. While 73.9% of the population lives within a 30-minute catchment zone that allows for timely access to blood transfusion, there are 33.4 million people living outside this range, and 13.8 million are living outside a 60-minute catchment area in what are effectively “blood deserts''. Policymakers and blood systems regulators must track both blood sufficiency and access. Our findings can provide evidence for policymakers and stakeholders to strategically allocate limited resources to ensure timely blood access when needed for all.
