A blood management system from a systemic perspective: development of an integrated model from regional blood supply to clinical transfusion decision-making
10.13303/j.cjbt.issn.1004-549x.2026.06.001
- VernacularTitle:基于系统视角的血液管理体系：从地区血液供应到临床输血决策的整合模型构建
- Author:
Changtai ZHU
1
;
Yunhua SUN
2
;
Lanjun ZHANG
2
;
Long HUANG
1
;
Qinyun LI
1
;
Heshan TANG
3
;
Yan ZANG
3
;
Junjie LIN
2
;
Baohua QIAN
3
Author Information
1. Department of Transfusion Medicine, The Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
2. Shanghai Blood Center, Shanghai Blood Management Office, Shanghai 200051, China
3. Department of Transfusion Medicine, The First Affiliated Hospital of Naval Medical University, The Shanghai Quality Control Center of Transfusion Medicine, Shanghai 200433, China
- Publication Type:Journal Article
- Keywords:
blood management;
blood supply;
voluntary blood donation;
clinical blood use;
transfusion decision-making;
model
- From:
Chinese Journal of Blood Transfusion
2026;39(6):699-710
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To address systemic challenges in the blood system, such as supply-demand imbalance, inefficient allocation, and inappropriate clinical use, while bridging gaps in current theories regarding the integration of social mobilization, institutional practice, and policy coordination. It sought to construct a system dynamics model spanning from macro to micro levels to analyze the blood management system holistically. Methods: Key variables were identified by a systematic literature search in both Chinese and English databases. An improved Delphi method was then employed to conduct expert consultations across different fields, leading to the selection and determination of core variable sets for each sub-model. Furthermore, by defining their logical relationships, a system dynamics model was constructed to systematically analyze the operation mechanism of the blood management system. Results: Four core sub-models were developed: 1) A macro "Dynamic Balance" model quantifying regional supply-demand equilibrium and inventory control; 2) a mobilization "Three-Layer Funnel" model analyzing how socio-cultural factors, service channels, and policy incentives influence donation behavior; 3) an institutional "Dual-Cycle Regulation" model revealing hospital blood usage is driven by both disease burden (demand cycle) and management practices (regulation cycle); and 4) an individual "Three-Layer Filter" model standardizing clinical transfusion decisions based on necessity, risk-benefit, and context. These were integrated into a "Multi-Layer Linkage and Feedback" model, elucidating bidirectional interactions among five levels: policy environment, regional supply, blood station mobilization, hospital application, and clinical decision-making. Conclusion: This study constructed a system dynamics model for blood management. By defining key variables and their logical relationships, it systematically analyzes the system′s operational mechanism. The integrated framework connects multiple levels—regional supply, voluntary donation, hospital blood use, and clinical decision-making—revealing their intrinsic linkages. Future efforts should employ systems thinking to synergistically enhance supply-side mobilization, demand-side management, systemic regulation, and decision standardization to build a safe, efficient, and sustainable blood security system.
