| ObjectiveTo systematically explore the macro policies,micro measures,and targeted group characteristics of blood donor incentives in mainland China.To investigate the effectiveness of current incentive policies and measures in promoting blood donation and their impact on blood safety,and to explore the feasibility of donor incentives in the context of voluntary unpaid blood donation in China.To accurately identify the targeted group for unpaid blood donation incentives in China-potential blood donors,clarify their group characteristics and incentive preferences,and provide a theoretical basis for subsequent targeted incentive measures.MethodsThe information on blood donor incentive policies and measures is derived from local blood donation regulations or implementation methods of blood donation laws.Annual blood donation-related data(number of blood donations,blood donation rate,unqualified blood screening rate,laboratory testing unqualified rate,etc.)from 31 provinces(autonomous regions,municipalities)in mainland China from 2000 to 2019 were collected through the National Blood Safety Report.Monthly blood donationrelated data from "Three Exemptions" policy areas from January 2010 to December 2021 were collected through surveys.From October to December 2022,online surveys of nonblood donors were conducted in a convenient sampling manner to collect their sociodemographic information,blood donation-related behavior,incentive measure preferences,factors affecting blood donation willingness,and blood donation intentions.The effectiveness of policies was evaluated through the generalized linear model of robust variance to test the differences in blood donation rates,and the average annual growth rate(AAGR)was used to compare dynamic changes in time series.Subgroup analysis was conducted based on regional distribution and per capita disposable income.The effectiveness of measures was evaluated by modeling data before and after measures were implemented using time series of blood donation numbers and comparing actual values with predicted values.Non-blood donors were classified into potential blood donors and non-potential blood donors according to their blood donation willingness.The chi-square test was used to compare the differences between potential and nonpotential blood donors in sociodemographic characteristics,personal blood transfusion experience,family and friends’ blood donation experience,self-perceived health status,blood donation information acquisition channels,reasons for not donating blood,and interest in incentive measures.The t-test was used to compare the differences in scores on life satisfaction,empathy,perceived needs,subjective norms,motivational drive,and convenience among different blood donation willingness groups.Logistic regression analysis was used to identify the factors influencing blood donation willingness.Results(1)The blood donation rate in mainland China has continued to increase for 20 years.In 2019,the blood donation rate in incentivized regions was higher than that in non-incentivized regions(11.6‰ vs 11.0‰,P<0.001),and the 20-year AAGR in incentivized regions was higher than that in non-incentivized regions(7.28%vs 5.31%).In 2019,based on geographical location,the blood donation rate in incentivized regions was higher than that in non-incentivized regions(P<0.001),except for the Northeast region,where the 20-year AAGR in incentivized regions was higher than that in nonincentivized regions.Based on disposable income,in 2019,the blood donation rate in incentivized regions was higher than that in non-incentivized regions in the upper-middle and high-income areas(P<0.001),and the 20-year AAGR at all income levels was higher in incentivized regions than in non-incentivized regions.(2)The national rate of blood donation screening failures is generally increasing,and the failure rate in incentivized regions is lower than that in non-incentivized regions.The ab solute growth rate of the overall failure rate in incentivized regions over 20 years was 3.79%,while that in non-incentivized regions was 6.87%.The laboratory testing failure rate is decreasing overall,and in 2019,there was no statistically significant difference in the testing failure rate between incentivized and non-incentivized regions(2.09%).The 20-year AAGR of blood expiration and scrapping in incentivized regions was lower than that in non-incentivized regions(17.78%vs 36.72%,P<0.001).(3)In the provinces of Zhejiang and Jiangsu,the actual number of blood donors after implementing incentive measures was higher than the predicted value,and the difference was statistically significant(P<0.05).However,in Hainan province,there was no statistically significant difference between the actual and predicted number of blood donors after implementing incentive measures(P=0.28).(4)A multiple logistic regression analysis of blood donation willingness was conducted among 2055 non-donors,and the results showed that being an only child,a friend’s history of blood transfusion,a family history of blood donation,a friend’s history of blood donation,perceived physical condition for blood donation,empathy,incentive drive,subjective norms,and convenience were the nine factors influencing blood donation willingness(P<0.05).Compared to non-potential donors,potential donors were more interested in incentive measures such as free blood use policies,publicity and recognition,information on blood test results,discounted public transportation cards,free scenic area tickets,proxy donations,knowledge of blood usage,and free parking(P<0.05).Conclusion(1)Incentives for blood donors in China can effectively promote blood donation without posing significant risks to blood safety or causing additional blood waste.(2)Non-economic incentives,such as those with symbolic honor meaning that cannot be bought,sold or traded,can effectively promote blood donation.However,their effects may have time lags in their manifestation.(3)Non-only children,those with friends or family members who have received blood transfusions or donated blood,those who believe they are physically capable of donating blood,those with higher levels of empathy,those who are more easily motivated by incentives,those with more support from close contacts,and those for whom blood donation is easier are more likely to become potential blood donors.(4)Compared to non-potential blood donors,potential blood donors are more interested in policies that offer free blood use,recognition and promotion,information on blood testing results,discounted public transportation cards,free admission to scenic areas,donation on behalf of someone else,knowledge of blood usage,and free parking. |
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