| Research objective:Based on the public product theory,the current work of unpaid blood donation in Chongqing was investigated in order to understand the problems in the unpaid blood donation in Chongqing and the underlying causes of these problems.On this basis,the situation of our country and foreign experience was combined to explore the health development countermeasures of the unpaid blood donation in Chongqing.Research method:1.Documentation method: Journal articles,books,government work documents and policy reports related to the current situation of unpaid blood donation were collected,analyzed,and summarized by taking advantage of CDMD database,CJFD database,and so on.2.The normative analysis method: By using the theory of public goods,logical reasoning was applied to the survey information and literature data have collected before.Based on Chongqing,China’s national conditionsand foreign experiences was combined to explore policies and measures for the healthy development of unpaid blood donation in Chongqing.3.Expert consultation method: Experts in the field of voluntary blood donation was chosen to provide suggestions on the design rationality of survey questionnaire and the interview outline,and to consult and demonstrate the strategy and advice of the later period.4.Questionnaire method: A site survey was conducted on 16 blood collection and supply institutions in Chongqing to understand the problems in the institution setting,blood donation and the situation of recruitment and propaganda.5.In-depth interview: The semi-structured in-depth interviews were conducted with the blood center,two central blood stations with the largest and smallest blood collection volumes,two central blood banks of independent and non-independent legal person and heads of blood transfusion department at three the top three hospitals,in order to understand the potential information that cannot be reflected in the data.Results:1.Establishment and clinical blood supply of blood transfusion services:In 2016,there were 139 blood collection points on the streets of Chongqing,of which 111 were mobile blood collection points and 28 were fixed blood collection points.The maximum blood supply service radius is 113 km,and the minimum is 29 km.The gap of blood services radius among bloodinstitutions is large;From 2014 to 2016,the per-capita blood use and the per-capita use of inpatient and surgery in Chongqing showed an overall upward trend,but the per-capita use of inpatient and surgery in blood donation station is in decline,showing a obvious contradiction between blood supply and demand;2.The situation of unpaid blood donation: In 2016,the rate for unpaid blood donation per thousand in Chongqing was 10.82‰ for the whole city,14.58‰ for blood centers,8.96‰ for central blood stations and 8.21‰ for central blood banks,which showed the low overall rate of blood collection and a large difference in the rate of blood donation per thousand at all levels of blood collection and supply institutions;From 2014 to 2016,the city’s blood collection volume was increasing year by year,with the largest increase in blood centers being 28.78%;The city’s whole blood donation was dominated by individual blood donation,and group donation is relatively low.The blood donation specification was mainly based on400 ml but the collection rate still needs to be improved.Apheresis platelets are based on 1 therapeutic volume;By the end of 2016,the number of RhD(-)blood donors in Chongqing was 2469,with 660(26.73%)in blood centers,1432(58%)in central blood stations and 377(15.27%)in central blood banks.3.Blood donation publicity and recruitment: The propaganda subjects are mainly blood collection and supply institutions,and the governmentrarely participates.The main methods of publicizing recruitment are street recruitment and advertising,while the new media such as WeChat,Weibo,and external websites were underdeveloped with the launch rates of56.25%,18.75%,and 37.50% respectively;From 2014 to 2016,the fund of publicity and souvenirs for unpaid blood donation generally showed a downward trend in Chongqing.The publicity funds were generally declining from 9,418,600 yuan in 2014 to 6,326,600 yuan in 2016,a decrease of nearly 33 percentage points.Souvenir funds for blood donation declined from 12,114,000 yuan to 11,911,100 yuan,a decrease of 1.65%.The two types of funds are mainly funded by the institutions themselves.The government financial allocation accounts for a relatively low proportion.In the past three years,the government investment in publicity funds has not exceeded 20%,and the maximum amount of souvenir funds has not exceeded 3.57%.Conclusion:1.Problems in the establishment of blood transfusion services: Large quantity,small size,and low rate of blood supply service radius;Unreasonable allocation of blood collection and supply regions,unbalanced blood supply,and lack of blood linkage and deployment mechanisms;A small number of fixed blood collection points.2.Problems in blood donations: Blood donation rate is generally low,and inter-institutional differences are relatively large;Blood donation ismainly individuals donation,and the proportion of group donation is too low;The collection rate of 400 ml whole blood and 2 therapeutic doses of platelet is low.3.Problems in the publicity and recruitment of unpaid blood donations:The government is absent,and the investment in publicity is insufficient;Lack of overall planning for publicity and recruitment,and some norms are old lag;There are defects in the propaganda model,and evaluation of propaganda effectiveness is lacking.Policy suggestion:1.Establishment of blood transfusion services: Optimize the setting of blood collection and plan the area of blood transfusion services rationally;Increase the number of fixed blood collection points and integrate institutions with a short blood service radius;Renew and improve relevant laws and regulations,and promote unpaid blood donation according to law.2.The publicity and recruitment of unpaid blood donations: Strengthen the responsibility of government and implement publicity funds;Establish a long-term mechanism and emphasis the top-level design;Assess the effectiveness of publicity and optimize the promotion model. |
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