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Impact of shifting blood donation policy from gift to honour model: staggered difference-in-differences analysis in China

Title: Impact of shifting blood donation policy from gift to honour model: staggered difference-in-differences analysis in China
Authors: Liu, Yuhao; Pan, Yiming; Zheng, Zhoutao; Pan, Bo; Zhang, Shiyu; Li, Ling; Zhao, Jinghan; Wei, Wen-Hua; Geldsetzer, Pascal; Bärnighausen, Till; Chen, Simiao; Liu, Zhong
Source: BMJ ; volume 392, page e084999 ; ISSN 1756-1833
Publisher Information: BMJ
Publication Year: 2026
Description: Objective To evaluate the impact of a new blood donation incentive policy—an honour model promoting blood donation quality and quantity to inform future policy changes in China and worldwide. Design Staggered difference-in-differences analysis in China. Setting Blood donation policies (from provincial government official websites), annual blood donation data (from China’s reports on blood safety and annual reports on development of China’s blood collection and supply industry), and demographic and socioeconomic indicators (from China city statistical yearbooks and provincial statistical yearbooks) from 2012 to 2018. Population Blood stations from 30 provinces of China; four regions excluded because data not available. Intervention The honour model (social recognition through an honour card granting frequent blood donors honorary incentives such as free access to public bus services and outpatient consultations in hospitals) was piloted to stimulate blood donations in intervention provinces. Main outcome measure Annual total count of blood donations and total count of whole blood donations to measure the quantity of blood donations, and annual donor eligibility rate to measure the quality of blood donations. Results The honour model increased blood donation counts by 3.55% (95% confidence interval 1.30% to 5.80%, P=0.003) by the end of the second year of implementation. By the end of the fifth year, this effect had doubled to 7.70% (2.42% to 12.98%, P=0.006). Most of these increases were driven by absolute increases in whole blood donation of 3.34% (1.11% to 5.56%, P=0.005) and 7.23% (1.90% to 12.56%, P=0.01) by the end of the second and fifth years, respectively. The honour model did not significantly affect the donor eligibility rate. The Borusyak-Jaravel-Spiess difference-in-differences analysis, synthetic difference-in-differences analysis, and placebo test all suggested the results were robust. Conclusions The honour model of blood donation increased the quantity of blood donation in China, while ...
Document Type: article in journal/newspaper
Language: English
DOI: 10.1136/bmj-2025-084999
Availability: https://doi.org/10.1136/bmj-2025-084999; http://data.bmj.org/tdm/10.1136/bmj-2025-084999; https://syndication.highwire.org/content/doi/10.1136/bmj-2025-084999
Rights: http://creativecommons.org/licenses/by-nc/4.0/
Accession Number: edsbas.20FF96DD
Database: BASE