全球智库信息集成服务系统

Overarching Findings

• The U.S. blood system under the status quo operates effectively and, in many cases, efficiently.
• The U.S. blood system is in a period of flux and uncertainty.
• There are unlikely but possible scenarios in which the supply of blood would be disrupted.

Threats to Sustainability

• The current system is not conducive to private investments in innovation.
• Suppliers to blood centers face significant uncertainty and contribute to concerns about sustainability.
• Services provided by local blood banks may be at risk.

Opportunities to Improve Sustainability

• Stakeholders want support in making technology adoption decisions.
• Blood center stakeholders are contemplating different market structures for the future.
• All stakeholders recognize the important role of blood as a public health good.

A robust, sustainable blood system is a crucial component of every health care system. The availability of safe blood and blood products is a prerequisite for various health care services — including some surgeries, treatments for cancer and other acute and chronic medical conditions, trauma care, organ transplantation, and childbirths — that extend and improve life for millions of patients annually.

This report describes the status quo in the U.S. blood system, explores a set of six specific research questions related to the sustainability of the U.S. blood system through analysis and discussion, and presents policy alternatives and tools that can help ensure that the U.S. blood system is sustainable. We employed a mixed-methods approach, blending insight from analyses of available data and from a series of interviews and other interactions with stakeholder groups.

Specifically, this report has the following three primary objectives: (1) describe the current blood system with a focus on relationships among key players and areas where market inefficiencies might exist; (2) outline potential opportunities to improve any identified inefficiencies and challenges under the current system, and explore the potential effects from changes in health care delivery, payment, technology, and clinical practice on blood supply, safety and prices; and (3) propose actionable solutions to the problems identified.

• Chapter One

  Introduction

• Chapter Two

  Overview of the U.S. Blood System

• Chapter Three

  Methods

• Chapter Four

  Trends Affecting Blood System Sustainability

• Chapter Five

  Payment for Blood and Health Care Services Involving Blood

• Chapter Six

  The Value of an Available Blood Supply

• Chapter Seven

  Emergency Preparedness Risk Assessment

• Chapter Eight

  Potential Innovation in Business Models

• Chapter Nine

  Best Practices from Other Nations' Blood Systems

• Chapter Ten

  Conclusion: Themes and Recommendations

• Appendix

  Interview Protocols