Maintaining an adequate blood supply for transfusion poses a pressing challenge to society. We argue that this challenge has not been adequately addressed in previous research. Building upon Healy’s seminal work on ‘blood-collection regimes’ and the subsequent shift towards a field-level approach that broadens the analytical focus beyond the dyadic relationship between donors and organizations, we embed the act of blood donation within the organizational field in which blood establishments operate. We assume that varying modes of governance shape the organizational practices of donor recruitment and blood collection. Our analysis is based on Eurobarometer data from 2014 (number of countries = 28; number of individuals = 19,363). The results identify considerable variance in donation rates according to field characteristics in terms of hierarchical centralization and competitiveness. Decentralized systems without competition perform worst in terms of the recruitment of (first-time) blood donors. Competitive systems in which several different bodies share responsibility for the provision of blood to patients yield the highest donation rates.
Inspired by the analytical shift toward understanding altruism from an institutional perspective, this article presents an empirical analysis of the impact of institutionalized solidarity on attitudes toward payment for blood or plasma donations, in terms of both the level of welfare provision and confidence in the welfare system. Postulating that institutionalized solidarity is intertwined with group-based solidarity, this article offers a more refined understanding of the relationship between institutional context and attitudes toward paid donation by incorporating measures of social cohesion in the analysis. Based on Eurobarometer data from 2014, the results indicate that support for cash payment for donation is lower in European countries where social spending is higher. Similarly, aggregated levels of trust in the social security system are associated with less support for payment for donation. These findings point to the importance of institutionalized solidarity for the manifestation of support for non-remunerated blood and plasma donation.
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