BACKGROUND

Intraoperative transfusion for gynecologic surgery, when appropriately used, can improve patient outcomes. However, when utilized incorrectly, blood transfusion can worsen patient outcomes and increase patient cost. This study aimed to evaluate the blood transfusion practices of tertiary hospitals in the Philippines.

METHODS

The study utilized a cross-sectional design wherein prospective data were gathered through multiple sources across seven tertiary-level hospitals. Women admitted to undergo gynecologic surgery were recruited based on a set of criteria. A chart review was conducted, and blood utilization indices were calculated. Outcomes were compared between public versus private facilities and transfused versus nontransfused patients.

RESULTS

Among 514 patients, 79.7% underwent cross-matching and 75.1% received transfusions. Adverse events were rare, with no transfusion-related deaths. The overall crossmatch-to-transfusion ratio (C/T ratio) was 2.8, exceeding the 2.5 optimal benchmark; all public hospitals recorded a C/T ratio >2.5, whereas private centers had more efficient usage. Six hospitals met acceptable benchmarks for transfusion probability and transfusion index. Open abdominal procedures, particularly hysterectomy, accounted for the most blood used. Transfused patients had longer operative times, greater blood loss, lower preoperative hemoglobin, and more frequently involved resident physicians in training. Public hospitals recorded higher cross-match and transfusion rates, greater resident physician participation, and broader use of general anesthesia.

CONCLUSION

Results of the study highlight the importance of monitoring blood transfusion parameters to optimize blood utilization. The observed differences between public and private institutions in the country highlight the urgent need for standardized and evidence-based practice to ensure efficient transfusion protocols nationwide.

Human ; Female ; Blood Transfusion

Background: Telemedicine has the potential of bridging the gap and achieving equity in receiving healthcare services. The department of health encouraged telemedicine using cell phones or consultations through social media platforms to decongest hospitals and reduce possible exposure to COVID‑19. Objectives: This study aimed to describe the effectiveness of telemedicine in increasing the self‑efficacy of patients with gestational trophoblastic neoplasia (GTN) in a tertiary hospital in Davao City. Materials and Methods: This research was a mixed method pre‑post‑test exploratory design with two main phases: a quantitative phase of assessing the effectiveness of telemedicine in increasing self‑efficacy to patients with GTN using Strategies Used by People to Promote Health‑29, and a qualitative phase of online focus group discussions of patients and health‑care workers. Thematic analysis was applied to contextualize the experience of the participants in engaging in telemedicine in the delivery of medical services. Results: Total subscale of self‑efficacy of the patients during the first consultation was high. The respondents had a high level of confidence in stress reduction and in making decisions. The respondents had a very high positive attitude. After 6 months of telemedicine, the total subscale of self‑efficacy was very high. The respondents had a high level of confidence in stress reduction and very high levels of confidence in making decision and positive attitude. The respondents had improved self‑efficacy and verbalized that telemedicine was easy and readily accessible. Conclusions Telemedicine helped the respondents improve their self‑efficacy. There was a significant difference between the baseline stress reduction and making decisions subscales after 6 months of utilizing telemedicine.
Gestational Trophoblastic Disease ; Telemedicine