Blood collection and donor motivation in Germany

Abstract

Background: The safety and availability of blood largely depends on committed, repeat donors who donate regularly over years and have a low risk of infectious diseases. Altruism is often reported by those repeat donors to be their major motivation. It is, however, unclear whether altruism is relevant for both non-remunerated and remunerated blood donors. Although the WHO rejects payments to blood donors, in Germany a monetary compensation for whole blood donors is permitted and some blood establishments offer such remuneration. The aim of this paper is therefore to describe donor motivation of non-remunerated and remunerated German first-time donors and to clarify whether remunerated donors are more likely to come back for further donations. Methods: We conducted a retrospective analysis of two donor surveys of 3077 nonremunerated and 738 remunerated first-time donors. The sample of the first donor survey consisted of non-remunerated donors who had started to donate blood in the year 2005 at a mobile collection site of the Red Cross Blood Service of Baden- Wurttemberg - Hessia in South-WestGermany. In 2009, a self-administered questionnaire was mailed to the selected donors including questions on motivation to donate blood. The sample of the second donor survey consisted of remunerated donors who had started to donate blood in the year 2006 at a university blood bank in South-WestGermany. In 2010, a self-administered questionnaire was mailed to the selected donors. We compared sociodemographic characteristics (age, sex, education) and selfreported motivation of remunerated and non-remunerated blood donors. Finally, the proportion of active donors among non-remunerated and remunerated donors after 2 years and after 4 years was calculated. Donors were categorized as 'active' if they had donated at least once in the last 24 months. Results: Among remunerated blood donors the proportion of men, young donors and high educated donors was significantly higher. Both remunerated and nonremunerated donors mentioned that they initially were activated by the intention to help others. Over half of the remunerated donors further reported that the remuneration was important or very important for their first donation. In the 24 months following the initial donation, remunerated donors were more likely to return for further donation. The proportion of active donors was 80.6% among remunerated and 74.4% among non-remunerated donors. A different picture emerged 4 years after the initial donation. The proportion of active remunerated donors declined to 63.3%, whereas the proportion of active non-remunerated donors only slightly decreased to 70.0%. Conclusion: Both non-remunerated and remunerated donors mentioned altruism as most important for blood donation. For many remunerated blood donors this seems to be a rationalization and not a motivation. Remuneration increases the likelihood of donors returning in the first months after the initial donation. Remuneration may therefore be used as a short-term strategy to recruit new donors. The long-term commitment, however, appears to be higher among non-remunerated first-time donors. Blood donor recruiting campaigns should therefore continue to appeal to altruism to recruit first-time donors that are likely to donate on a routine basis.