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UBC Theses and Dissertations

Optimal issuing policies for hospital blood inventory Slofstra, Anyu


Red blood cells (RBCs) are the most common type of blood cells and the primary means of delivering oxygen throughout the body. They are perishable with a permitted storage time of forty-two days in Canada and in the United States. RBCs undergo a series of pathological changes while in storage. These pathological changes are known as storage lesions, and they have a negative impact on the amount of oxygen delivered to the tissue during transfusion. As a result, many studies have been conducted on the age of blood used in transfusion to patient outcomes over the past two decades. Although conflicting results have been found, most studies find that the age of blood used in transfusion plays a role in disease recurrence and mortality. Therefore, we are interested in studying hospital blood issuing policies, and in finding ones that can minimize hospital blood shortages and wastages while reducing the age of blood used in transfusion. In this thesis, we first formulate our problem as a Markov Decision Process (MDP) model, and find optimal policies that minimize blood shortages, wastages, and age of blood used in transfusion, individually. We then use simulation to compare eleven policies, including a Myopic policy derived from the MDP model. We find policies that minimize the average expected total cost of blood shortages, wastages, and age of blood used in transfusion for various shortage and wastage costs. We also perform sensitivity analyses of total costs with respect to varying threshold and cost parameters.

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