Research On The Service Ability Of Blood Collection And Supply Institutions In Chongqing

Objectives:Based upon the theory of public products and government regulations,this study aims to investigate the service ability of Blood Collection and Supply Institution,including the current situation of supply and demand,infrastructures,economical status,human resources,and information construction.Problem-solving based policies are expected to be carried out for better understanding in on-site problems and factors involved.Research methods:1.Literature search : We conducted a thoroughly literature search for studies conducted on blood collection and supply and published in either English or Chinese in several databases including Chinese Selected Doctoral Dissertations Master’s Theses Full-Text Database(CDMD),Chinese Journal Full-Text Database(CJFD),VIP Journals Database,Pub Med,Med line and EBSCO.In addition,we screened several Web sites(World Bank,the WHO,the foreign ministry of health,the American association of blood Banks(AABB),the international association of bloodtransfusion(ISBT))for assessments on blood transfusion for supplemental information.Relevant dates were extracted for in-depth analysis.After analyzing the evolution and trends in this field,conclusions were reached about research achievements,existing problems and possible related policies.2.Expert consultation: Selected experts in health management and who are familiar with the process of blood collection and supply,provided advises on the rationality of the questionnaire and interview syllabus.They also make suggestions on later period.3.Questionnaire survey: We issued a self-designed questionnaire named “The Service Ability of Blood Collection and Supply Institution in Chongqing” to 16 Blood Collection and Supply Institutions to figure out the current situation of supply and demand,institution structural establishment and coverage area,institution infrastructures and blood donate spots,economical status and human resources,and information management means,etc.4.In-depth interviews: To dig more potential information,one governor from municipal centre blood bank,two managers from county centre blood bank where least and largest blood consumption lies,two leaders from blood collection spots in legal entity independently and dependently and blood transfusion department chiefs from three different hospitals were semi-structured in-depthly interviewed.Information werecollected such as flaws during the process of blood transfusion,influenced factors and lessons we could learn from.5.Statistical analysis methods: The recycling questionnaire was coded.Excel 2003 was used for data entry and sorting,and SPSS statistics software was used to analyze the data.Research results:1.Current situation of supply and demand:(1)From 2014 to 2016,the consumption on blood in Chongqing increased year by year and the increase rate is 14.10%.The number of blood donation increased from262.9 thousand times to 307 thousand times.The blood donation rate of thousand people reached 10.82 per thousand in 2016.(2)From 2014 to2016,the blood supply in Chongqing rose from 371,700 U to 433,400 U,the number of patients in medical institutions increased from 134.2649 million to 149.0706 million,the number of beds in medical institutions increased from 154.700 thousand to 190.900 thousand,the number of inpatients increased from 5.4859 to 5.9946 million,and the number of procedures increased from 991.300 to 1.985 thousand.2.Institution infrastructures:(1)Of the 16 blood collection and supply institutions,the available housing area of the county central blood bank of Dazu and Dianjiang did not meet the standard according to the Ministry of Health.Housing area was beyond the standard range of service ability can match in Nanchuan,Hechuan and Rongchang county centre blood bank.And the problems of housing and construction for a few blood supply and supply institutions have not been solved.(2)Of the 16 blood collection and supply institutions,only 5 meet the standard service radius according to Guiding Principles For Blood Collection And Supply Institutions.(3)In2016,there were 52 blood donate facilities in Chongqing,including 41 blood buses and 11 blood houses and there are 139 places where blood can be collected in total across the city,of which 111 were flowing and 28 were fixed.3.Human resources:(1)There are total 866 workers,of which 485 are staffed,accounting for 56%.(2)The educational background contains technical and undergraduate college,accounting for 44.3% and 32.7%respectively while the master degree and above only accounting for 4.8%.(3)As for position allocation,professionals in technique make up to 73.4%.(4)Of all,the professional title gives first place to the primary title(58.3%)while senior title only accounts for 9.9%.(5)In centre blood banks in municipal and county,the average number of blood staffs per 5000 U was8.05,including 5.64 health technicians and 2.41 non health technicians in2016.4.Economical status:(1)Of the 16 institutions on forms of fund management,12 of them manage by incomes and expenditure separately,while 3 manage by them selves,1 is other form.(2)9 institutions operate by full government allowance,5 institutions operate by making up thebalance and 2 hold responsible for themselves profit and loss.(3)The annual income of the institutions increased year by year,reaching 381.1873 million yuan in 2016,of which the government allowance was relatively low,only 20.49%.The income mainly came from the blood compensation,accounting for 36.28%.(4)In 2014-2016,16 blood collection and supply institutions,except Fengjie county central blood bank,have good economic performance and low asset liability ratio,which was less than 15%.The asset liability ratio of Fengjie county central blood bank has been over 52%in the past 3 years,which meets a large financial risk.5.Information construction:(1)There are 36 information management stuff across the city,of which 15(41.67%)are full-time and 21(58.33%)are part-time.(2)The usage rates of firewall,intrusion monitoring,VNP and Internet behavior management are 56.25%,75%,43.75% and 25%respectively.(3)By the end of 2016,only 31.25% institutions had completed the construction of external websites.56.25% had set up WeChat platform and 18.75% had built micro-blog platform.Research conclusions:1.Problems in supply and demand: Blood donation rate is generally low and differences between different institutions are relatively large.Contradiction between blood supply and demand is prominent.Imbalance between blood demand and supply in regional allocation.2.Problems in institution infrastructures: Too many institutions in number.Unreasonable allocation of housing area.Blood donation places are set too few.3.Problems in human resources: Unreasonable structure of human resources.High proportion of non-authorized strength.Lack of planning of human resources training.4.Problems in economical status: Insufficient budget from the government.The government’s financial input to the institutions is quite different,hence the development at all levels is unbalanced.There is a large financial risk for the excessive dependence of the institutions on the income of blood compensation.5.Information construction: Lack of interactive platform aiming at information and resource sharing.Lack of information management professionals and problems solving depends on the developers.Information service platform needs to be improved.Policy recommendations:1.Optimize departments settings and plan for better room usage.2.Infrastructures to be used wisely,balance the usage between blood donation and work room,and provide convenience for blood service.3.Human resources to be used wisely,Strengthen training of specific stuffs and improve team construction.4.Strengthen the responsibility of government financial input,increase financial input,and ensure the healthy development of blood collection and supply institutions.5.Strengthen the awareness of information management,value the training of information specific team,improve information service platform,and improve the ability of information construction.