January 9, 2012
Will there be blood? Yes, if donors are compensated, research shows
While U.S. hospitals struggle to maintain adequate blood supplies, a new study co-authored by a Johns Hopkins University business professor shows that economic incentives can significantly increase donations from the public.
In addition, the findings suggest that similar methods could be used to build up lifesaving supplies of human bone marrow, organs and body parts for transplantation.
Incentives could be strategically employed to attract blood donations at times when blood supplies are particularly low, such as holidays and summer months, according to the working research paper by Mario Macis of the Johns Hopkins Carey Business School and two co-authors, Nicola Lacetera of the University of Toronto and Robert Slonim of the University of Sydney.
“Because of the big gap between supply and demand, as an economist I wanted to know whether economic incentives could be introduced into this market that would stimulate people to donate blood. We learned that this was indeed the case,” Macis said in an interview.
The study found that an advertised offer of a $5 gift card increased the likelihood of giving among people with a history of donating by 26 percent, a $10 gift card produced a 52 percent rise, and a $15 card caused an uptick of 72 percent. The offer of gift cards even caused people to motivate others to donate, including people who previously had never given blood.
The study examined individual data from nearly 100,000 donors at 72 American Red Cross blood drives in northern Ohio from September 2009 through August 2010. Gift cards were offered at half the blood-drive sites; no incentives were provided at the other sites, which served as controls for the study.
Macis said that the research has implications beyond blood reserves. It suggests that some form of compensation, though on a greater scale, could bring a much-needed boost to the supplies of organs, body parts and bone marrow for transplants.
Selling blood, organs and body parts for cash is illegal in the United States. However, donors of blood plasma can be paid. Also, a federal appellate court ruled Dec. 1 that most donors of bone marrow can receive compensation, overturning a law that had made such arrangements punishable by up to five years in prison.
“There’s this feeling among many people that organs, for example, must be donated freely and without any compensation. But as the need becomes more severe, it may be time to reconsider this view and look at how shortages in a number of categories can be reduced by offering some form of compensation for donations,” Macis said. “We believe that our study contributes the kind of hard data with sound, thorough, empirical analysis that can shift this debate away from the emotional reactions that tend to dominate it. Of course, the type and amount of compensation, and product quality, would have to be very highly regulated, but the result could be a huge payoff for society.
“Doctors and other medical professionals are financially rewarded for saving lives,” he said. “Why not do the same for ordinary citizens who save lives by donating their blood or organs or marrow?”
The research further reveals that many of the donors with advance notice of a gift-card offer switched the locations and dates of their usual blood donations to sites where the rewards would be available. As the authors note, this process of “displacement” signals a potential way to increase donations in areas and at times of the year that see the worst shortages.
Another noteworthy finding is the decreased rate of subsequent donations by people who had no advance notice of the rewards and who were surprised with gift cards just after they gave blood. The researchers theorize that these donors might have seen the unexpected gifts as an affront to their intrinsic motivation to commit a social-minded act, and consequently, many chose not to donate again. All of them, however, accepted and subsequently spent their gift cards.
The paper, which received funding from the National Science Foundation, is titled “Rewarding Altruism? A Natural Field Experiment.” It was circulated as a National Bureau of Economic Research working paper and as a Milton Friedman Institute working paper.