Incentive Preferences Of Blood Donors In Shandong Province

Blood is a valuable medical resource,and blood transfusion therapy is an important tool in clinical treatment.Since the implementation of the Blood Donation Law in 1998,the number and the volume of blood donations in China have increased continuously for more than 20 years.However,the blood supply still faces the following challenges:First,the growth rate of blood donation cannot catch up with the rapidly growing demand for medical services.Second,with the deepening of the aging of society,the number of age-appropriate blood donors will be further reduced.Furthermore,blood donation is an important livelihood project,especially for major natural disasters,epidemics and wartime blood supply.Final,China’s blood supply is in a tight balance,with regional,seasonal and paratypical blood supply tensions,indicating that there is still much room for improvement in the cause of blood donation in China.The central and local governments have enacted a series of blood donation incentives to encourage blood donation.Nevertheless,it is unclear whether and to what extent these incentives will promote blood donation behavior.The study found that attitudes toward incentives varied across populations and that motivation to donate blood changed over time.Meanwhile,traditional Chinese culture may discourage people from donating blood.Therefore,it is necessary to explore the preferences of Chinese blood donors for incentives,to develop more targeted strategies for donor retention,and to improve the incentive mechanism for blood donation in China.The aim of this study was to elicit incentive preferences of Chinese blood donors using a discrete choice experiment(DCE),to explore the preference heterogeneity among blood donor populations,and to provide reliable preference evidence for the establishment of a sound incentive mechanism,so as to build a stable pool of blood donors for the growing demand of blood.The specific research objectives include:(1)to record in detail the whole process of determining attributes and levels by combining qualitative and quantitative methods,and to provide a reference for future attribute development;(2)to measure the incentive preferences of blood donors,and to clarify the relative importance among incentives(i.e.,attributes);(3)to explore the preference heterogeneity among blood donor populations,and to provide scientific and reliable preference information for the incentive mechanisms for blood donation.To obtain comprehensive,operable,and reasonable attributes and levels for the subsequent DCE,a targeted literature review,in-depth interviews,attribute ranking,a focus group,and pilot studies were conducted.A D-optimal design was developed using SAS software to generate 18 choice sets.To reduce the burden on the respondents,the 18 choice sets were divided into 3 blocks.Meanwhile one of the choice sets was repeated to test the consistency of responses.Each respondent was asked to answer 7 discrete choice experiment questions.We selected 3 cities to represent eastern(Yantai),middle(Jinan)and western(Heze)in Shandong Province according to geographical location and the level of economic development.This study used paper questionnaires,one-on-one,and face-to-face interviews for data collection.The questionnaires in Jinan were collected by the research members,and offline training was mainly targeted at Heze and Yantai blood station staff,who completed the questionnaire collection on their behalf.To organize and analyze the collected data:(1)Data entry was performed using EpiData software,and the DCE data were processed using effect coding;(2)The appropriate DCE econometric model was selected based on the purpose of the study and the type of data;(3)The results of blood donors’ incentive preferences for blood donation were interpreted through the regression coefficient of the main effects model;(4)Based on the results of the main effects model,the relative importance of each attribute,willingness to discard,interaction analysis,policy simulation analysis and subgroup analysis were further calculated.A total of 650 donors were invited,of which 477 were included for analysis.The respondents were predominately male(64.6%),young adults(61.0%),and well-educated people(59.9%).Respondents preferred comprehensive health examination,family members as recipients,central government recognition,30-minute travel time,and a gift valued at RMB 60.No significant differences were found between the model results of forced and unforced choice setting.Blood recipient was the most important attribute,followed by gift and health examination,and then honor and travel time.Respondents were willing to discard RMB 32 for an improved health examination and RMB 69 for changing the recipient from themselves to family members.Policy simulation analysis predicted 80.3%of donors would endorse the new incentive profile if the recipient was changed from themselves to family members.Furthermore,our analysis identified distinct preference patterns among various subgroups.Young donors,first-time donors,and group volunteers placed a higher value on travel time than gift,while middle-aged and elderly donors,repeat donors,and individual volunteers exhibited the opposite preference,deeming gift more important than travel time.Parameter of the opt-out option was estimated significantly with a negative sign,indicating respondents preferred to choose one of the incentive programs instead of the opt-out option.This study is the first study in China to apply discrete selection experiments in the field of blood donation,and the first study in China to document in detail the process of determining attributes and levels using a combination of qualitative and quantitative methods,providing a scientific and standardized reference for the subsequent development of attributes and levels.The main conclusions of this study are as follows:(1)The combination of qualitative and quantitative methods is an effective attribute development tool;(2)Privileged receiver was the primary consideration for incentive preferences,and the most important stimulus was immediate relatives as preferred blood receivers rather than donors themselves;(3)Small gifts were attractive incentives and offering items of limited value was a safe strategy for donor retention;(4)Both health check and travel time were considerations and their relative importance was roughly equal;(5)Donation appreciation were less important compared with the other attributes.This study put forward the following suggestions from four perspectives:(1)It is recommended to use a combination of qualitative and quantitative methods to determine attributes and levels which can better optimize the quality of preference studies;(2)The smooth implementation of policies related to blood use preferences should be ensured,and the blood use reimbursement process should be continuously optimized;expand the coverage of existing relatives to include close relatives such as brothers and sisters,as long as they are financially affordable;(3)Small gifts have lower costs and are easy to achieve in the short term.We should actively innovate the types of small gifts.For example,developing blood donation cultural and creative brands and selecting the most beloved small gifts through online voting;(4)It is important to locate blood mobiles in close proximity to population centers,or at places of employment where most people prefer to donate.In addition,more blood mobile visits to campuses,institutions,enterprises should be arranged to shorten travel time;(5)Blood services should be notified of blood test results timely and consider providing more health-related information,such as comprehensive checkups.Moreover,the opportunity for health screening can be transferred to parents,increasing the public’s motivation to donate blood.