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Article(id=1320438127785783349, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320438090615862080, articleNumber=null, orderNo=null, doi=10.11847/zgggws1148568, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1753891200000, receivedDateStr=2025-07-31, revisedDate=1760025600000, revisedDateStr=2025-10-10, acceptedDate=1763481600000, acceptedDateStr=2025-11-19, onlineDate=1792746582218, onlineDateStr=2026-10-23, pubDate=1775750400000, pubDateStr=2026-04-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792746582218, onlineIssueDateStr=2026-10-23, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792746582218, creator=13701087609, updateTime=1792746582218, updator=13701087609, issue=Issue{id=1320438090615862080, tenantId=1146029695717560320, journalId=1319373219989389464, year='2026', volume='42', issue='4', pageStart='385', pageEnd='512', issueExtLink='null', onlineDate='null', pubDate='1775750400000', pubDateStr='2026-04-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792746573356, creator='13701087609', updateTime=1792748076043, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1320444393430040620, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320438090615862080, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1320444393430040621, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320438090615862080, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=494, endPage=499, ext={EN=ArticleExt(id=1320438128037441590, articleId=1320438127785783349, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Blood shortage crisis and solutions under China′s non-remunerated blood donation system: a brif discuss, columnId=1320431897281413811, journalTitle=Chinese Journal of Public Health, columnName=Public Health Forum, runingTitle=null, highlight=null, articleAbstract=

While China has established a comprehensive whole-process management system covering blood collection, testing, and allocation for its non-remunerated blood donation system, the contradiction between blood supply and demand has become increasingly prominent against the backdrop of deepening population aging and growing demand for medical services, creating a blood shortage crisis. This paper analyzes the causes of this crisis and concludes that the crisis arises from factors such as public misperceptions and distrust, disorderly cost control across the blood supply chain, and an imperfect rights protection system. It proposes targeted solutions: recommending the use of legal mechanisms to address policy implementation discrepancies, enhancing the transparency of blood management to rebuild public trust, and optimizing blood allocation efficiency to tackle geographical disparities. These measures are essential to safeguard and enhance the value of China′s non-remunerated blood donation system.

, authors=Siyu TAO1, 2, Yunxian LI3, Qiyu CHEN4, Linxiu REN1, 2, Lidong NI2, authorsList=Siyu TAO, Yunxian LI, Qiyu CHEN, Linxiu REN, Lidong NI, authorCompany=null, correspAuthors=Lidong NI, authorNote=null, correspAuthorsNote=
NI Lidong, E-mail:
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我国无偿献血制度虽已构建覆盖血液采集、检测、调配的全流程管理体系，但在人口老龄化程度加深和医疗服务需求增长的背景下，血液供需矛盾问题凸显，形成“用血难”困境。本文通过专家咨询、文献分析和现场调研等方法分析了用血困境成因在于公众科学认知偏差与信任危机、血液全链条成本控制失序、权益保障体系不完善等因素，并针对性地提出破解路径，建议通过法治化手段消除政策执行差异，需强化血液管理透明度以重建公众信任，优化血液调配效率以应对区域失衡，保障并提升我国无偿献血制度价值。

, authors=陶思羽1, 2, 李韵羡3, 陈琪玉4, 任林琇1, 2, 倪黎冬2, *, *, authorsList=陶思羽, 李韵羡, 陈琪玉, 任林琇, 倪黎冬, authorCompany=null, correspAuthors=倪黎冬, authorNote=

陶思羽（1993—），助理研究员，博士，研究方向：健康政策、医院管理、医保管理

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倪黎冬，E-mail：
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(2024-06-19)[2025-08-14]. http://www.enshi.gov.cn/xw/esxw/202406/t20240619_1588202.shtml., articleTitle=null, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1320438128519786552, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438127785783349, xref=1, ext=[AuthorCompanyExt(id=1320438128528175161, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438127785783349, companyId=1320438128519786552, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai 200025, China), AuthorCompanyExt(id=1320438128544952378, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438127785783349, companyId=1320438128519786552, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1上海交通大学中国医院发展研究院，上海 200025)]), AuthorCompany(id=1320438130222673979, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438127785783349, xref=2, ext=[AuthorCompanyExt(id=1320438130235256892, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438127785783349, companyId=1320438130222673979, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China), AuthorCompanyExt(id=1320438130243645501, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438127785783349, companyId=1320438130222673979, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2上海交通大学医学院，上海 200025)]), AuthorCompany(id=1320438130306560062, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438127785783349, xref=3, ext=[AuthorCompanyExt(id=1320438130314948671, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438127785783349, companyId=1320438130306560062, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3School of Management, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China), AuthorCompanyExt(id=1320438130327531584, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438127785783349, companyId=1320438130306560062, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3成都中医药大学管理学院，成都 611137)]), AuthorCompany(id=1320438130386251841, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438127785783349, xref=4, ext=[AuthorCompanyExt(id=1320438130398834754, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438127785783349, companyId=1320438130386251841, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=4Law School, Anhui University, Hefei 230601, China), AuthorCompanyExt(id=1320438130407223363, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438127785783349, companyId=1320438130386251841, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=4安徽大学法学院，合肥 230601)])], figs=[ArticleFig(id=1320438132504375397, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438127785783349, language=EN, label=Tab.1, caption=

Practical experience of solving blood shortage problems in various regions of China

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方向代表省/市（州）主要做法
法律保障上海市、江西省1. 上海市出台《上海市献血条例》规定“献血者自献血之日起5年内按献血量的5倍免费用血，5年后按等量免费用血”，通过法律形式明确了用血费用减免的数量、时间范围[27]。
2. 江西省出台《江西省献血条例》明确将献血年龄延长至65周岁、设立“无偿献血宣传月”等创新举措，以立法细化无偿献血管理，为地方立法提供上位法依据[28]。
激励机制青岛市、深圳市、义乌市1. 青岛市推出成分献血“积分商城”，献血者献血会积累成分血积分，可用于兑换文创产品、乘车券、限量盲盒等特色礼品[29]。
2. 深圳市将精神激励融入日常，如建立徽章和感谢状文化、向献血者颁发专属感谢状、为18岁成人礼/生日等特殊纪念日献血者举办仪式等[30]。
3. 义乌市“信用献血”试点，献血达一定数量可增加个人信用积分，信用积分可用于提升住房公积金贷款额度、享受免费停车等[31]。
技术赋能浙江省、北京市1. 浙江省推出“用血服务不用跑”项目，通过数字化改革打通了血站、公安、民政、卫健系统等的数据库，献血者需用血时可通过系统自动获取证明材料，各用血医院也能实时同步查看和标记献血者方便主动予以优先用血和血费减免保障[32]。
2. 北京市红十字血液中心推出“千兆光网+人工智能采供血服务平台”，引入可穿戴设备、AI、物联网等技术，可以实时监测多名献血者体征指标、提供24小时采供血热线AI服务、血液资源“一物一码亿仓格”精准定位调配等[33]。
社会动员福州市、恩施州1. 福州市以世界献血者日为契机开展月度系列宣传活动，推出了为在活动期间参加无偿献血的献血者赠送爱心感谢礼开展无偿献血科普知识线上问答、在媒体刊登热血团体光荣榜和热血达人风采、启动地铁爱心专列等活动。同时，通过献血点布置及多屏联动宣传，让献血者感受到浓厚的节日氛围，增强献血者的荣誉感[34]。
2. 恩施州推出“一袋血 两份爱”公益品牌活动，每年3—5月献血者在任意献血点献血一次，血站配额支出关爱资金2元，用于激励和支持参与无偿献血的优秀学子[35]。
), ArticleFig(id=1320438132588261478, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438127785783349, language=CN, label=表1, caption=

国内各地破解用血困难的实践经验

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方向代表省/市（州）主要做法
法律保障上海市、江西省1. 上海市出台《上海市献血条例》规定“献血者自献血之日起5年内按献血量的5倍免费用血，5年后按等量免费用血”，通过法律形式明确了用血费用减免的数量、时间范围[27]。
2. 江西省出台《江西省献血条例》明确将献血年龄延长至65周岁、设立“无偿献血宣传月”等创新举措，以立法细化无偿献血管理，为地方立法提供上位法依据[28]。
激励机制青岛市、深圳市、义乌市1. 青岛市推出成分献血“积分商城”，献血者献血会积累成分血积分，可用于兑换文创产品、乘车券、限量盲盒等特色礼品[29]。
2. 深圳市将精神激励融入日常，如建立徽章和感谢状文化、向献血者颁发专属感谢状、为18岁成人礼/生日等特殊纪念日献血者举办仪式等[30]。
3. 义乌市“信用献血”试点，献血达一定数量可增加个人信用积分，信用积分可用于提升住房公积金贷款额度、享受免费停车等[31]。
技术赋能浙江省、北京市1. 浙江省推出“用血服务不用跑”项目，通过数字化改革打通了血站、公安、民政、卫健系统等的数据库，献血者需用血时可通过系统自动获取证明材料，各用血医院也能实时同步查看和标记献血者方便主动予以优先用血和血费减免保障[32]。
2. 北京市红十字血液中心推出“千兆光网+人工智能采供血服务平台”，引入可穿戴设备、AI、物联网等技术，可以实时监测多名献血者体征指标、提供24小时采供血热线AI服务、血液资源“一物一码亿仓格”精准定位调配等[33]。
社会动员福州市、恩施州1. 福州市以世界献血者日为契机开展月度系列宣传活动，推出了为在活动期间参加无偿献血的献血者赠送爱心感谢礼开展无偿献血科普知识线上问答、在媒体刊登热血团体光荣榜和热血达人风采、启动地铁爱心专列等活动。同时，通过献血点布置及多屏联动宣传，让献血者感受到浓厚的节日氛围，增强献血者的荣誉感[34]。
2. 恩施州推出“一袋血 两份爱”公益品牌活动，每年3—5月献血者在任意献血点献血一次，血站配额支出关爱资金2元，用于激励和支持参与无偿献血的优秀学子[35]。
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我国无偿献血制度下用血困境及其破解路径探析
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陶思羽 1, 2 , 李韵羡 3 , 陈琪玉 4 , 任林琇 1, 2 , 倪黎冬 2, *, *
中国公共卫生 | 公共卫生论坛 2026,42(4): 494-499
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中国公共卫生 |公共卫生论坛 2026 , 42 (4) : 494 -499
我国无偿献血制度下用血困境及其破解路径探析
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陶思羽1, 2, 李韵羡3, 陈琪玉4, 任林琇1, 2, 倪黎冬2, *, *
作者信息
  • 1上海交通大学中国医院发展研究院，上海 200025
  • 2上海交通大学医学院，上海 200025
  • 3成都中医药大学管理学院，成都 611137
  • 4安徽大学法学院，合肥 230601
通讯作者:
倪黎冬，E-mail：
作者简介:

陶思羽（1993—），助理研究员，博士，研究方向：健康政策、医院管理、医保管理

Blood shortage crisis and solutions under China′s non-remunerated blood donation system: a brif discuss
Siyu TAO1, 2, Yunxian LI3, Qiyu CHEN4, Linxiu REN1, 2, Lidong NI2
Affiliations
  • 1China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai 200025, China
  • 2Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • 3School of Management, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
  • 4Law School, Anhui University, Hefei 230601, China
    • Corresponding Author:
    NI Lidong, E-mail:
出版时间: 2026-04-10 doi: 10.11847/zgggws1148568
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摘要
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我国无偿献血制度虽已构建覆盖血液采集、检测、调配的全流程管理体系，但在人口老龄化程度加深和医疗服务需求增长的背景下，血液供需矛盾问题凸显，形成“用血难”困境。本文通过专家咨询、文献分析和现场调研等方法分析了用血困境成因在于公众科学认知偏差与信任危机、血液全链条成本控制失序、权益保障体系不完善等因素，并针对性地提出破解路径，建议通过法治化手段消除政策执行差异，需强化血液管理透明度以重建公众信任，优化血液调配效率以应对区域失衡，保障并提升我国无偿献血制度价值。

无偿献血制度  /  用血困境  /  血液管理

While China has established a comprehensive whole-process management system covering blood collection, testing, and allocation for its non-remunerated blood donation system, the contradiction between blood supply and demand has become increasingly prominent against the backdrop of deepening population aging and growing demand for medical services, creating a blood shortage crisis. This paper analyzes the causes of this crisis and concludes that the crisis arises from factors such as public misperceptions and distrust, disorderly cost control across the blood supply chain, and an imperfect rights protection system. It proposes targeted solutions: recommending the use of legal mechanisms to address policy implementation discrepancies, enhancing the transparency of blood management to rebuild public trust, and optimizing blood allocation efficiency to tackle geographical disparities. These measures are essential to safeguard and enhance the value of China′s non-remunerated blood donation system.

non-remunerated blood donation system  /  blood shortage crisis  /  blood management
陶思羽, 李韵羡, 陈琪玉, 任林琇, 倪黎冬. 我国无偿献血制度下用血困境及其破解路径探析. 中国公共卫生, 2026 , 42 (4) : 494 -499 . DOI: 10.11847/zgggws1148568
Siyu TAO, Yunxian LI, Qiyu CHEN, Linxiu REN, Lidong NI. Blood shortage crisis and solutions under China′s non-remunerated blood donation system: a brif discuss[J]. Chinese Journal of Public Health, 2026 , 42 (4) : 494 -499 . DOI: 10.11847/zgggws1148568
正文
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无偿献血制度作为保障临床用血安全的基石，在维护公共卫生安全和推动健康中国建设中具有不可替代的战略价值。自1998年《中华人民共和国献血法》（下文简称《献血法》）实施以来，我国已构建起覆盖血液采集、检测、储存、调配的全流程管理体系，为临床诊疗、医疗技术发展及重大公共卫生事件处置提供了有力保障。然而，随着人口老龄化进程的加快与医疗服务需求的增长，血液供需矛盾日益凸显，区域性、季节性缺血现象常态化，血液成本高昂引发患者经济负担加重，献血者权益保障机制与政策执行效能不足等问题，已形成制约医疗公平与制度可持续发展的现实瓶颈。这些困境不仅影响急危重症患者的救治时效，更可能影响公众对无偿献血制度的信任感，对其对策研究具有理论价值和实践意义。本文通过梳理我国无偿献血制度建设情况、剖析当前无偿献血制度下我国用血困境及其原因，有针对性提出优化路径，旨在为破解献血动力不足、用血成本高昂、血液调配低效等问题提供优化策略，以期保障健康中国战略实施。
1　无偿献血制度下我国用血政策背景
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1.1　多层次血液供给支持体系已初步构建
在法治框架构建方面，以1998年《中华人民共和国献血法》为制度基石，通过2019年国家卫生健康委员会会同十一部委联合印发的《关于进一步促进无偿献血工作健康发展的通知》，建立多部门协同治理机制，并将无偿献血工作纳入全国文明城市测评体系，实现制度保障的法定化与常态化。
1.1.1　运行机制创新
通过2021年实施的《全国血站服务体系建设发展规划（2021—2025年）》强化区域血液应急调配能力，同时形成“团体预约献血为主、街头流动献血为辅”的供给模式，配套电子献血证系统提升服务效能。2025年国家卫生健康委办公厅印发的《关于进一步落实“血费减免一次都不跑”工作的通知》进一步要求全国所有的血站和用血医疗机构全面落实献血者无论何地献血、何地用血均可线上办理血费减免的政策，持续优化献血用血服务流程，提升献血者体验。
1.1.2　激励政策体系构建
全面推行包含公共交通、景区游览、基础医疗三类优待的“三免政策”，并建立两年周期的国家级表彰制度。数据显示，截至2022年全国已经完成11届无偿献血表彰，合计表彰献血者达250余万人，2022—2023年度表彰达77万余人次[1]，形成物质激励与精神奖励并重的长效机制。
1.2　用血费用减免服务效能提升
我国用血费用减免服务体系的核心改革聚焦于破解报销流程复杂、地域壁垒突出等现实难题。目前在无偿献血者的用血费用减免上，我国系统重构了“申请—审核—结算”的减免链条，一是打破户籍限制，建立跨省异地减免平台；二是消除纸质证明依赖，通过电子献血证实现数据互联核验；三是压缩审批环节，将传统“事后报销”升级为“用血即免”服务模式。2024年11月“全国电子无偿献血证”小程序在线办理无偿献血者血费跨省异地减免申请，形成医疗机构窗口直免为主、政务平台线上办理为辅的双轨服务体系。
1.3　血液监管主体逐渐明晰
国家卫生健康委作为血液管理的核心监管主体，构建了“三位一体”的法规体系：以《血站管理办法》确立采供血机构的准入标准与运行规范[2]，《医疗机构临床用血管理办法》强化医疗机构用血责任[3]，《血站质量管理规范》建立血液制品全过程质量指标体系[4]。《全国血站服务体系建设发展规划（2021—2025年）》提出4级监管架构——国家负责战略规划与标准制定，区域中心承担技术指导与应急调配，省级部门实施日常监管，市级机构落实属地管理，形成纵向贯通、横向协同的立体化监管网络[5]。
2　无偿献血制度下我国用血困境的主要表征
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2.1　血液短缺产生供需矛盾
血液至今无法人工合成，无偿献血是临床用血的唯一来源，但血液供给长期难以匹配需求增速。2024年我国无偿献血1 582万人次，献血量2 692万单位，千人口献血率达11.4[6]。但随着人口老龄化的加剧与医疗技术的发展，近年来全国临床用血需求不断增长，而同期献血人次的增长率未能与之匹配，导致血库库存持续紧张[1]，供需缺口呈持续扩大趋势。此外，区域失衡问题较为突出。在部分经济欠发达或地理位置偏远的区域，由于医疗资源相对匮乏，献血宣传和动员力度不足，导致献血率相对较低，血液库存量不足[5]。血液调配的难度也因地理位置偏远而加大，血液运输成本高、时间长[7]。血液的季节性短缺问题也同样显著，冬季或夏季极端天气条件下，献血活动受天气影响较大[8]，加之流感等疾病高发，影响人们的献血意愿和健康状况，加剧了血液短缺的紧张局势[9]。
2.2　血液收费标准较高，加重患者经济负担
现行血液收费标准较高，患者需承担采集、检验、储存及运输全链条成本[10]。医院输血800 mL 的费用约为1 600～2 000元之间[11]，尽管具体的费用会根据医院的收费标准、地区经济水平以及血液成分等因素有所不同，但总体用血费用相对较高，给患者带来较大的经济压力。用血费用减免政策虽规定献血者及其亲属可享受成本费用减免，但实施中存在报销比例不足、报销流程效率低下等问题：报销比例上，非献血者仅能覆盖部分成本费用，且部分地区报销金额上限为献血量的2～3倍[12]，难以应对大剂量输血需求；报销流程上，有调查结果显示，献血者前往血站报销血费不仅费时、费力，还需额外承担往返交通费用，实际费用较高[13]。此类低效报销机制与直接费用叠加，加剧了患者经济负担，形成“用血难—经济困”的恶性循环。另外，目前我国临床用血费用虽已纳入医保报销范围，但医保报销覆盖的力度和范围却因地区、医保类型等不同而存在较大差异，大多数患者仍面临较高的用血成本。
2.3　献血者权益保障不充分
我国通过《献血法》确立献血者及其亲属的优先用血权，但政策执行层面的系统性缺陷导致权益保障不充分。一方面，由于献血者对自身权益的认知不足，源于宣传机制缺位与信息共享梗阻。献血过程中缺乏权益告知标准化流程，导致献血者对免费用血期限、异地用血申请程序等核心条款认知模糊[14]。部分医院与血站因信息共享机制缺失且工作人员对政策的理解偏差，致使长期献血者遭遇用血障碍，医疗机构与血站数据孤岛直接削弱了政策的执行力。另一方面，地方政策设计偏离实操逻辑。部分地方政府为激励献血而制定的“超量权益条款”存在制度性矛盾。部分地区推行“翻倍免费用血”政策，但未同步建立血液库存动态监测与优先权分级标准，在血液资源紧张时难以兑现承诺。各省献血者免费用血标准也存在差异。广东省献血200 mL即可无限量免费用血[15]，而北京则需达到1 000 mL[16]。这种区域政策碎片化加剧了执行混乱。
3　无偿献血制度下我国用血困境的原因分析
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3.1　公众献血意愿低
出现用血困境的关键症结在于缺血。首先，公众献血意愿受制于系统性科学认知的缺失。目前仍有部分潜在献血者存在“献血导致免疫力下降”等认知误区，这种认知偏差根源于科普机制的结构性缺陷[17]。当前对于献血的宣传聚焦道德倡导，忽视血液再生机制等核心科学原理的阐释。此外，受传染病等因素影响，献血者的风险规避倾向导致献血行为减少[18]。第二，血液管理机制透明度不足引发公众信任危机。一方面，我国血液管理系统尚未建立统一、公开透明的信息平台，献血者在献血后难以追踪自己所献血液的流向和使用详情。这种不确定性削弱了公众对无偿献血制度的信任基础。另一方面，血液中蕴含着个人的敏感基因信息，公众担心这些信息在献血过程中可能遭遇泄露，从而引发一系列隐私安全问题[19]。
3.2　临床用血成本高
临床用血费用主要包含直接成本与间接成本两大模块。直接成本包括血液采集费用（如血液初检费用、采血材料费用、献血纪念品、交通补贴）、血液检测试剂费用、血液分离及深加工所需血袋及相关耗材费用、储存及运输费用等；间接成本则涵盖设备折旧费、水电费等与血液采供过程相关的费用。血液从采集到使用的过程中，涉及多个环节，每个环节都需要投入相应的人力、物力和时间，从而增加了血液的总体成本。血液检测需使用先进设备和专业技术人员，储存运输需特殊条件和设备，如低温保存、冷链运输，以保障血液品质[20]。
3.3　献血者权益保障体系不完善
3.3.1　法律设计
《献血法》及相关部门工作文件已明确规定了献血者及其亲属在临床用血时的优惠待遇，包括费用减免及优先用血权等，体现了对献血行为的正面激励。但其关键缺陷在于缺乏指导性的统一执行标准，导致地方政策在执行过程中各行其道，甚至做出不切实际的承诺，削弱了激励措施的有效性和公信力，引发公众对献血制度的误解。例如，《献血法》仅原则性规定了“优先用血”，却未统一明确优先权的触发条件、时效范围及核验标准等核心细节，这使得部分地区在实际执行中缺乏明确依据，最终导致部分献血者应享的合法权益受损。
3.3.2　政策落实
地方执行不力问题凸显，部分地区在推进政策过程中进度迟缓，未能遵循国家层面的鼓励性指导政策，导致政策效果大打折扣。此外，地方政策制定中的自由裁量权过大，也影响了政策的公平性与有效性。
3.3.3　宣传力度
献血者权益的普及工作存在不足。献血者对于自身在献血后应享有的用血权益往往不清楚，献血时权益信息传达不到位，导致献血者在需要用血时对自己的权益知之甚少，错失便利用血机会而导致用血困难。
4　国际经验的本土化启示
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4.1　日本荣誉表彰制度
日本建立了全国献血荣誉表彰制度，将参与次数与表彰奖励直接挂钩，在献血活动中做出重要贡献的个人和团体可以获得国家授予的荣誉奖项。例如，献血达到10、30或50次就会赠送一份“精选纪念品”，献血70次和100次会分别获得银功勋章和金功勋章，参与献血活动达5年以上的献血团体、推进者等会获得感谢状和有功章[21]。制度实施后，献血人次逐年增长，到2023年全国献血人次超500万，千人口献血率上升到39.85[22]。其成功经验表明，将献血行为与公民的自我价值体现和社会荣誉感相结合，能形成可持续的激励机制。与我国部分地区的零散奖励或短期激励不同，日本的核心特点在于将表彰升级为全国统一、等级清晰的国家层面制度，通过国家荣誉认证和阶梯式激励体系强化长期吸引力，这对我国建立健全全国统一的献血荣誉体系和长期激励机制具有借鉴意义。
4.2　新加坡多样献血活动
新加坡为吸引并促进更多人定期参与献血，在新加坡红十字会和卫生科学局的携手努力下推出了品牌联名、社区合作、公司学校举行活动等多样化的献血者招募计划和献血宣传活动。例如，包括政府机构、医院、学校和知名品牌在内的60多个自主从其官方网站、社交媒体平台和品牌标识中删除了代表血型的字母A、B、O的“失踪类型运动”，在新加坡引起了极大的轰动，该活动在启动当月的献血量就增加了16%[23]。2024年针对18～25岁献血人数下降问题，发起了“Youthinspire”计划，积极鼓励该年龄段青年通过参与活动、自主社媒宣传等推广献血、参与献血[24]。这些多元化的宣传激励活动成功构建了可持续的献血文化认同，对加强献血知识宣传、吸引潜在献血者具有重要作用。相较于我国常见的通用型献血宣传，新加坡的特别之处在于既针对特定人群的献血率下降设计专项计划，又联合政府、企业、品牌形成传播合力，这种精准化、多主体协同的模式，能有效提升活动转化率，为我国设计差异化献血动员方案和扩大献血宣传影响力提供了重要参考。
4.3　法国全国统一数据库
法国于1999年根据献血法案成立的法国血液中心（EFS）是法国境内唯一的负责血液和血液制品采集、检验、储存等的公共权威机构。EFS建立了全国统一的献血者数据库，包括稀有血型献血者资料，献血者在首次献血时需要在EFS官网注册、完成问卷测试和现场评估，个人信息、健康状况、生物检测结果等相关数据均会被保存到献血者的健康档案，并通过全国部署的统一IT系统确保献血者数据的实时互联互通[25]。《欧盟的献血：探索创新干预措施的行为洞察》（Blood donation in the EU: exploring behavioural insights for innovative interventions）报告指出，法国建立的统一献血者数据库投入应用后，该国2021年全国重复献血率达到85%[26]。这有力证明了简化行政程序、建立统一互通信息化系统对提升献血积极性的关键作用。我国虽开展献血者数据库建设相关工作，但多存在地区分散管理、数据不通等情况，而法国的核心优势在于依托统一数据库实现献血全流程数据互通，既简化献血者跨区域操作流程，又保障数据统一性，这对我国整合现有资源、建立国家级献血信息平台具有借鉴价值。
5　国内实践的经验启示
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经过多年无偿献血工作的实践探索，我国各地结合区域特征与发展阶段需求，从法治保障、激励优化、技术赋能等多维度创新举措，形成了一些具有代表性的区域实践经验（表1），为破解用血困境提供了多元化的解决方案。
6　无偿献血制度下我国用血困境的解决路径
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6.1　完善法治保障，优化献血者激励机制
要健全以《献血法》为核心的法律法规体系，在法律层面实现三大突破：一是建立全国统一的献血者身份识别系统，并配套《血液信息管理办法》，严格规范数据采集标准、访问权限及安全防护措施，参照《中华人民共和国网络安全法》设定违规处罚条款。通过生物识别技术与居民身份证信息绑定，彻底打破省际数据壁垒，实现“一地献血、全国认可”的无障碍服务。二是明确献血记录永久有效的法律地位，废止地方性时效规定，确保献血者终身享有《献血法》赋予的权益，包括优先用血权、直系亲属免费用血权等。第三设立专门的血液权益争议仲裁委员会，通过立法授权其调取医疗机构、血站等全链条数据，建立标准化纠纷处理流程，重点解决因历史档案缺失、跨省信息不互通导致的权益认定难题。同时，探索形成“基础权益+特色激励+长效保障”的多元化激励政策体系。在基础权益层面，建议构建全国统一的献血贡献量化标准，将献血次数、献血量与医保报销比例梯度挂钩，同时可考虑将献血记录纳入社保卡功能模块，实现“一卡通”式权益管理。在特色创新方面，可系统推广青岛“积分商城”模式，建立动态调整的积分兑换体系，除常规体检套餐、家庭医生服务外，还可拓展至公共交通优惠、文化场馆免费参观等民生领域；同时参考深圳“城市礼遇”建设经验，构建全国性类似优待机制，将献血者分级纳入城市公共服务优待范围，享受人才公寓优先分配权、公立医院专家号预约绿色通道等差异化待遇。在长效保障维度，可借鉴浙江省“信用献血”的试点经验，向累计献血超4 000 mL者授予诚信市民称号，配套创业贷款贴息、子女入学加分等跨领域激励，形成“献血—信用—社会回报”的良性循环。通过制度设计让献血者的奉献获得可持续的社会认同。
6.2　完善医保报销体系与技术创新协同降低用血成本
强化医保覆盖与费用监管。首先，要加大用血费用报销的医保覆盖力度。通过政策引导和财政补贴，确保医保基金能够更广泛地覆盖用血费用，对于经济条件较差的患者，应提供更为精准和有力的经济援助。如设立专项基金，以减轻其经济压力。同时，简化报销流程，减少不必要的手续和证明材料，提高报销的便捷性和时效性，确保患者能够在第一时间获得经济支持。此外，明确具体的实施措施，加强对用血费用报销的监管。建立健全监管机制，加强对医疗机构和医保部门的监督，防止拒绝报销、乱收费等问题的发生。定期审计和检查医疗机构的用血费用报销情况，严肃处理违规行为。提高用血费用的透明度，通过公示用血费用明细、报销流程和标准等方式，让患者和社会公众能够清晰地了解用血费用的构成和报销情况，确保用血费用的公开透明、合理合法，切实减轻患者的用血负担。优化血液技术应用与成本控制。鼓励血液采集、储存、分离及检验等环节的技术创新。通过引入先进的自动化、智能化设备，提高血液处理的效率和质量，有效减少人为错误，降低因操作不当导致的成本增加。建立血液质量追溯系统，利用信息技术监控和管理血液的全过程，确保血液的安全性和可追溯性。建立健全血液成本核算体系。通过精细化核算与控制血液采集、检测、储存、运输等各个环节的成本，清晰了解成本构成，找出成本控制的关键点。加强内部管理，减少不必要的环节和开支，提高资源利用效率，从源头上降低血液的制备成本。政府应增加对血站基础设施建设、设备更新和技术研发的资金支持，提高血站的服务能力和运营效率。通过合理的定价机制，确保血液价格能够反映其成本和价值，避免因价格过高而增加患者的用血负担。
6.3　构建“教育—文化—技术”三位一体的公众参与促进机制
6.3.1　教育奠基，将无偿献血知识纳入国民教育体系
教育是塑造观念、传递知识的重要途径，通过在中小学和大学等不同教育阶段开设相关课程，系统地向学生传授无偿献血的意义、流程、注意事项及献血者的权益等知识，树立正确的献血观念，认识到献血不仅是一种个人行为，更是一种社会责任和奉献精神的体现。同时，通过组织形式多样的课外活动和社会实践，如参观血站、参与献血志愿服务、开展献血知识竞赛等，让学生在实践中加深对无偿献血的理解和体验，增强参与意识和行动力。
6.3.2　文化引导，利用媒体力量传播正能量
传统媒体如电视、广播、报纸等，具有广泛的受众基础和较强的影响力，应充分发挥其优势，定期开设无偿献血专题栏目或节目，深入报道无偿献血的感人故事、先进人物和成功案例，以生动鲜活的案例感染和激励公众。新媒体平台如互联网、社交媒体、短视频等，具有传播速度快、覆盖面广、互动性强等特点，应积极运用这些平台，发布无偿献血的相关信息和内容，与公众互动交流，及时回应疑问，增强宣传的时效性和针对性。通过举办献血主题的艺术展览、文学创作比赛、微电影展映等活动，以文化人、以文育人，将无偿献血的理念融入文化艺术创作中，用艺术的形式传递献血的正能量，激发公众的情感共鸣和参与意愿，提升无偿献血在社会文化中的地位和影响力。
6.3.3　技术赋能，运用大数据、云计算等现代信息技术手段
通过精准定位目标人群，实现个性化宣传，向其推送符合其需求和兴趣的无偿献血信息，提高宣传的精准度和有效性。例如，针对不同年龄段、不同职业、不同地区的公众，制定差异化的宣传策略和内容，以满足他们的个性化需求。还可以利用虚拟现实（VR）等高科技手段，模拟献血场景，让潜在献血者在虚拟环境中体验献血的过程，普及献血相关知识，减轻对献血的恐惧心理和顾虑，增强参与意愿和信心，从而吸引更多人参与到无偿献血中。

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doi: 10.11847/zgggws1148568
  • 接收时间：2025-07-31
  • 首发时间：2026-10-23
  • 出版时间：2026-04-10
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  • 收稿日期：2025-07-31
  • 修回日期：2025-10-10
  • 录用日期：2025-11-19
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    1上海交通大学中国医院发展研究院，上海 200025
    2上海交通大学医学院，上海 200025
    3成都中医药大学管理学院，成都 611137
    4安徽大学法学院，合肥 230601

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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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