Unpaid blood donors and their spouses and immediate family members can be exempted or reduced in accordance with relevant regulations when they need blood clinically, but in reality, some blood donors and their families use blood in different places, reimburse blood expenses, and apply for relevant commendations, etc., there is a problem of "cross-provincial" obstruction.
"I went to university in Beijing, during which I participated in 9 unpaid blood donations, accumulating 3,200ml. After returning to his hometown to work, when his family members were sick and hospitalized and needed blood, they were told that the blood donation certificate from other provinces could not reduce the cost of blood use locally. Recently, Xiaohan (pseudonym) in Hebei told reporters about the situation he had encountered.
According to the relevant provisions of the Blood Donation Law of the People's Republic of China (hereinafter referred to as the "Blood Donation Law"), citizens only pay for the collection, storage, separation, and testing of blood when they use blood clinically. Unpaid blood donors are exempt from these fees when they need blood clinically; When the spouses and immediate family members of unpaid blood donors need blood clinically, they may be exempted or reduced from paying the fees provided for in the preceding paragraph in accordance with the provisions of the people's governments of provinces, autonomous regions, and municipalities directly under the Central Government.
However, the reporter learned in the interview that in reality, some unpaid blood donors face problems such as the inability to reimburse blood expenses across provinces and the non-mutual recognition of blood donation certificates in other places.
Stuck on "inter-provincial".
In March 2024, Mr. Lei from Shaanxi Province also encountered a similar problem with Xiaohan. He went to university in Nanchang, Jiangxi Province, and later worked in Xi'an, and since his freshman year, he has donated a total of 5,200ml of blood.
According to the "National Measures for Commendation and Reward of Unpaid Blood Donation (2022 Edition)", Mr. Lei could have won the Bronze Award for Unpaid Blood Donation for his cumulative blood donation. "But after many inquiries, the blood bank said that it could not apply for the award for me, because my blood donation locations are not 'unified', and the blood volume statistics between the blood stations in each province are independent."
According to local requirements, Mr. Lei only donated blood three times in Xi'an, with a total of 1,200ml, which did not meet the requirement of 4,000ml. Therefore, Mr. Lei suggested on the "leadership message board" of a website: "I hope that the database of blood donation stations can be interconnected across the country." ”
Since the implementation of the Blood Donation Law in 1998, the mainland has established a voluntary unpaid blood donation system. In 2015, the former National Health and Family Planning Commission, the Red Cross Society of China and other four departments issued the "Opinions on Further Strengthening Blood Management", pointing out that the establishment of a national overall guidance, provincial (regional, municipal) unified blood management information system, to achieve regional blood stations, medical institutions, blood donor information networking. The opinion also pointed out that the work of blood dispensing should be standardized, and an inter-provincial blood supply linkage mechanism should be established in accordance with the law.
A few days ago, the reporter called the blood centers of many provinces, and found that the data and information areas of most provinces have realized the connection of blood stations, medical institutions, and blood donors. However, whether it is blood donors and their families who use blood in other places, reimburse blood expenses in other places, or just apply for relevant commendations like Mr. Lei, there are "cross-provincial" obstruction problems.
Where exactly is the blockage?
In September 2019, the National Health Commission issued a notice requiring cross-regional unpaid blood donors to be directly exempted from clinical blood costs, and to establish a unified blood reduction and exemption platform for the whole province.
In January 2024, the National Health Commission and other six departments jointly issued the "Notice on Further Improving the Incentive and Reward Work of Unpaid Blood Donors", mentioning that it will continue to promote the direct reduction and exemption of blood costs for unpaid blood donors and their relatives when they are discharged from the hospital. At present, 28 provinces have achieved direct reduction and exemption of blood fees for unpaid blood donors and their relatives in hospitals in the province.
"The reimbursement of related blood expenses needs to be registered and reimbursed at the place of blood donation, and if you donate blood from other provinces, we do not have relevant information and data here, so we cannot handle it directly." The staff of the blood station in Xi'an Central City, Shaanxi Province and other blood stations told reporters that the main reason why cross-provincial reimbursement cannot be made is because the data is not networked. "For example, if an immediate family member needs to use blood, he can only use blood first and then settle it normally in the hospital, and then prepare a reimbursement voucher according to the specific requirements of the blood donation place and return to the blood donation place for reimbursement."
An industry insider, who did not want to be named, said that there are many reasons for the difficulty of using blood in different places and reimbursing across provinces in reality. In addition to the cross-provincial non-network of blood donation data and information, clinical blood use and blood supply are often in a tight balance, especially in the case of seasonal ischemia.
In addition, there is the issue of inconsistent reimbursement standards. The Blood Donation Law stipulates that the provincial (autonomous regional, municipal) governments shall formulate detailed implementation rules for the Blood Donation Law, so the return standards, reimbursement and exemption standards vary from place to place, which increases the obstacles to cross-provincial blood reimbursement and reduction.
Wang Peng, an associate researcher at the Beijing Academy of Social Sciences, believes that the fundamental reason is that the mainland has not yet established a perfect mechanism for sharing information on blood donation and blood use and coordinating blood use in other places. This leads to the fact that the rights and interests of blood donors cannot be fully protected when blood is used in other places, and it also affects the coordination and cooperation between medical institutions and blood banks.
The construction of a national database may be on the agenda
According to the data of the seventh national population census, in 2020, the total floating population in China reached 376 million, an increase of 69.73% from 2010. Among them, the inter-provincial floating population was 125 million, an increase of 45.37%. The participation of the population in the flow of people has increased substantially, and the scale of the floating population has further expanded. In this context, it is very necessary to solve the problems of blood use in other places and reimbursement in other places.
The reporter learned that in order to ensure more scientific, reasonable and efficient blood management, promote the sharing of hospital blood inventory information with blood stations and health administrative departments, and improve the optimal allocation and quality and safety of blood, in accordance with the "Notice of the Medical Emergency Department of the National Health Commission on Carrying out the Pilot Work of Clinical Blood Information Networking in Medical Institutions", Beijing, Shanghai, Zhejiang, Anhui and other places took the lead in carrying out networking pilots.
At present, Beijing has realized the direct reduction and exemption of blood fees for blood donors and their relatives in medical institutions in Beijing, and has built a unified platform for blood fee reduction and exemption in the whole city. The whole city can be handled through direct reduction and self-service through the app. In addition, the staff of the Beijing Red Cross Blood Center told reporters that blood donors and their spouses and immediate family members who donate blood for free in Beijing can reduce or exempt the prescribed clinical blood fees across provinces.
In June 2019, Zhejiang's "Direct Exemption for Non-local Blood Hospitals" service was officially launched, and blood donors in any part of the province can directly apply for blood reduction and exemption in hospitals that have opened relevant services in the province. In the same year, Shanghai and Suzhou realized the emergency linkage of cross-provincial blood donation, and the reimbursement of blood in other places also began to be piloted.
Wang Peng said that in order to further dredge the "inter-provincial" blockages, first of all, it is necessary to improve it from the institutional level. For example, a nationwide information sharing platform for blood donation and blood use should be established to realize the real-time update and interconnection of data such as blood donor information, blood inventory information, and blood demand information. Secondly, promote digital transformation and intelligent upgrading, and improve the intelligent level of blood management.
"It is very necessary to establish a normalized emergency blood linkage mechanism." Wang Peng believes that the smooth operation of the linkage between the province and the province can ensure the rapid mobilization and distribution of blood resources in emergency situations, strengthen the communication and cooperation between medical institutions and blood stations, improve the efficiency of treatment, and at the same time, help improve the enthusiasm of the people to participate in unpaid blood donation.
Source: CCTV