Problems and challenges: development of blood transfusion services in Mainland China within the context of health‐care system reform

SUMMARY Objective To evaluate the development of blood transfusion services in Mainland China within the context of health‐care system reform. Background China launched a health‐care reform program in 2009 to redistribute health‐care resources, which are currently over‐concentrated in well‐developed cities. A geographically equitable blood transfusion service is key to achieving this goal. Methods Based on the national survey of blood establishments in July 2015, total blood collection, whole‐blood donations per 1000 population and the supply and demand relationship were analysed at the administrative region level. Areas at different developmental levels were compared in terms of total blood collection and human resources. Results In 2014, Mainland China's 31 provinces showed wide variation, with total blood collection in blood facilities ranging from about 1000 units to over 600 000 units (each 200 mL), and the whole‐blood donation rate per 1000 population, ranging from 1·48 to 17·09. 69% of the country's total collection, was concentrated in 29 provincial capitals, and 31% was in 311 non‐capital cities. Of 97 personnel with doctorates, 74 worked in 32 provincial blood establishments, whereas the remaining 23 worked at the other 318 blood stations. In most provinces, per permanent resident donation was within 2–4 mL, and blood volume per inpatient was 10–35 mL regardless of the development of the transfusion service. Conclusion In 2014, China had an imbalanced development and insufficient access to blood transfusion services. This service must be redeployed at the national level to facilitate health‐care reform in China.