Healthy donor effect and satisfaction with health
Abstract
The objective of this paper is to quantify selection effects related to blood donation behavior and their impact on donors’ perceived health status. We rely on data from the 2009 and 2010 survey waves of the German socio-economic panel (N = 12,000), including information on health-related, demographic and psychographic factors as well as monetary donation behavior and volunteer work. We propose a propensity score matching approach to control for the healthy donor effect related to the health requirements for active blood donations. We estimate two separate models and quantify selection biases between (1) active and inactive blood donors and (2) active donors and non-donors. Our results reveal that active donors are more satisfied with their health status; after controlling for selection effects, however, the differences become non-significant, revealing selection biases of up to 82 % compared with non-donors. These differences also exist between active and inactive donors, but the differences are less distinct. Our methodological approach reveals and quantifies selection biases attributable to the healthy donor effect. These biases are substantial enough to lead to erroneous statistical artifacts, implying that researchers should rigorously control for selection biases when comparing the health outcomes of different blood donor groups.
Keywords
Propensity score matching Blood donation services Socio-economic panel Donor managementJEL Classification
I12 C83 C21 I14Supplementary material
References
- 1.Glynn, S.A., Kleinman, S.H., Schreiber, G.B., Zuck, T., Mc Combs, S., Bethel, J., Garratty, G., Williams, A.E.: Motivations to donate blood: demographic comparisons. Transfusion 42(2), 216–225 (2002)CrossRefPubMedGoogle Scholar
- 2.World Health Organization (2013). http://www.who.int/mediacentre/factsheets/fs279/en/. Accessed 22 Aug 2013
- 3.Ascherio, A., Rimm, E.B., Giovannucci, E., Willett, W.C., Stampfer, M.J.: Blood donations and risk of coronary heart disease in men. Circulation 103, 52–57 (2001)CrossRefPubMedGoogle Scholar
- 4.Salonen, J.T., Tuomainen, T.P., Salonen, R., Lakka, T.A., Nyyssonen, K.: Donation of blood is associated with reduced risk of myocardial infarction. The Kuopio Ischaemic Heart Disease Risk Factor Study. Am J Epidemiol 148, 445–451 (1998)CrossRefPubMedGoogle Scholar
- 5.Zacharski, L.R., Chow, B.K., Howes, P.S., Shamayeva, G., Baron, J.A., Dalman, R.L., Malenka, D.J., Ozaki, C.K., Lavori, P.W.: Decreased cancer risk after iron reduction in patients with peripheral arterial disease: results from a randomized trial. J Natl Cancer Inst 100(14), 996–1002 (2008)CrossRefPubMedGoogle Scholar
- 6.Atsma, F., de Vegt, F.: The healthy donor effect: a matter of selection bias and confounding. Transfusion 51(9), 1883–1885 (2011)CrossRefPubMedGoogle Scholar
- 7.Atsma, F., Veldhuizen, I., Verbeek, A., de Kort, W., de Vegt, F.: Healthy donor effect: its magnitude in health research among blood donors. Transfusion 51(8), 1820–1828 (2011)CrossRefPubMedGoogle Scholar
- 8.Benyamini, Y., Idler, E.: Community studies reporting association between self-rated health and mortality: additional studies 1995 to 1998. Res Aging 21(3), 392–401 (1999)CrossRefGoogle Scholar
- 9.DeSalvo, K., Bloser, N., Reynolds, K., He, J., Muntner, P.: Mortality prediction with a single general self-rated health question: a meta-analysis. J Gen Intern Med 21(3), 267–275 (2006)PubMedCentralCrossRefPubMedGoogle Scholar
- 10.Mossey, J.N., Shapiro, E.: Self-rated health: a predictor of mortality among the elderly. Am J Public Health 72(8), 800–808 (1982)PubMedCentralCrossRefPubMedGoogle Scholar
- 11.Idler, E., Benyamini, Y.: Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav 38(1), 21–37 (1997)CrossRefPubMedGoogle Scholar
- 12.Nielsen, S., Brit, A., Siersma, V., Hiort, C., et al.: Self-rated general health among 40-year-old Danes and its association with all-cause mortality at 10-, 20-, and 29 years’ follow-up. Scand J Public Health 36(1), 3–11 (2008)CrossRefPubMedGoogle Scholar
- 13.Jylhä, M., Volpato, S., Guralnik, J.: Self-rated health showed a graded association with frequently used biomarkers in a large population sample. J Clin Epidemiol 59(5), 465–471 (2006)CrossRefPubMedGoogle Scholar
- 14.Banks, J., Crossley, T., Goshev, S.: Looking for private information in self-assessed health. In: HEDG Working Paper. University of York (2007)Google Scholar
- 15.Bond, J., Dickinson, H., Matthews, F., Jagger, C., Brayne, C.: Self-rated health status as a predictor of death, functional and cognitive impairment: a longitudinal cohort study. Eur J Ageing 3(4), 193–206 (2006)CrossRefGoogle Scholar
- 16.Edgren, G., Reilly, M., Hjalgrim, H., Tran, T.N., Rostgaard, K., Adami, J., Titlestad, K., Shanwell, A., Melbye, M., Nyren, O.: Donation frequency, iron loss, and risk of cancer among blood donors. J Natl Cancer Inst 100, 572–579 (2008)CrossRefPubMedGoogle Scholar
- 17.Burnett, J.J.: Psychological and demographic characteristics of blood donors. J Consum Res 8(1), 62–66 (1981)CrossRefGoogle Scholar
- 18.Veldhuizen, I.J.T., Doggen, C.J.M., Atsma, F., De Kort, W.L.A.M.: Donor profiles: demographic factors and their influence on the donor career. Vox Sang 97(2), 129–138 (2009)CrossRefPubMedGoogle Scholar
- 19.Nguyen, D.D., DeVita, D.A., Hirschler, N.V., Murphy, E.L.: Blood donor satisfaction and intention of future donation. Transfusion 48(4), 742–748 (2008)PubMedCentralCrossRefPubMedGoogle Scholar
- 20.Condie, S., Maxwell, N.: Comparative demographic profiles: voluntary and paid blood donors. Transfusion 10(2), 84–88 (1970)CrossRefPubMedGoogle Scholar
- 21.Ibrahim, N.A., Mobley, M.F.: Recruitment and retention of blood donors: a strategic linkage approach. Health Care Manage Rev 18(3), 67–73 (1993)CrossRefPubMedGoogle Scholar
- 22.Ringwald, J., Zimmermann, R., Eckstein, R.: Keys to open the door for blood donors to return. Transfus Med Rev 24(4), 295–304 (2010)CrossRefPubMedGoogle Scholar
- 23.Rubin, D., Thomas, N.: Matching using estimated propensity scores: relating theory to practice. Biometrics 52(1), 249–264 (1966)CrossRefGoogle Scholar
- 24.Caliendo, M., Scheel-Copeinig, S.: Some practical guidance for the implementation of propensity score matching. J Econ Surv 22(1), 31–72 (2008)CrossRefGoogle Scholar
- 25.Roy, A.: Some thoughts on the distribution of earnings. Oxf Econ Pap 3(2), 135–145 (1951)Google Scholar
- 26.Imbens, G.W.: Nonparametric estimation of average treatment effects under exogeneity: a review. Rev Econ Stat 86(1), 4–29 (2004)CrossRefGoogle Scholar
- 27.Mithas, S., Krishnan, M.S.: From association to causation via a potential outcomes approach. Inf Syst Res 20(2), 295–313 (2009)CrossRefGoogle Scholar
- 28.Heckman, J.J., Ichimura, H., Todd, P.: Matching as an econometric evaluation estimator. Rev Econ Stud 65(2), 261–294 (1998)CrossRefGoogle Scholar
- 29.Krupp, H.J.: Das Sozio-oekonomische Panel (SOEP)–Genese und Implementation. In: SOEP-papers on multidisciplinary panel data research, pp. 2–16. DIW, Berlin (2007)Google Scholar
- 30.Lee, L., Piliavin, J.A., Call, V.R.A.: Giving time, money, and blood: similarities and differences. Soc Psychol Q 62(3), 276–290 (1999)CrossRefGoogle Scholar
- 31.Andaleeb, S.S., Basu, A.K.: Explaining blood donation: the trust factor. J Health Care Mark 15(1), 42–48 (1995)PubMedGoogle Scholar
- 32.Bekkers, R.: Traditional and health-related philanthropy: the role of resources and personality. Soc Psychol Q 69(4), 349–366 (2006)CrossRefGoogle Scholar
- 33.Boulware, L.E., Ratner, L.E., Ness, P.M., Cooper, L.A., Campbell-Lee, S., LaVeist, T.A., Powe, N.R.: The contribution of sociodemographic, medical, and attitudinal factors to blood donation among the general public. Transfusion 42(6), 669–678 (2002)CrossRefPubMedGoogle Scholar
- 34.Hofmann, A., Browne, M.: One-sided commitment in dynamic insurance contracts: the market for private health insurance in Germany. J Risk Uncertain 46(1), 81–112 (2013)CrossRefGoogle Scholar
- 35.Burnett, J.J.: Examining the profiles of the donor and nondonor through a multiple discriminant approach. Transfusion 22(2), 138–142 (1982)CrossRefPubMedGoogle Scholar
- 36.Newman, K., Pyne, T.: Service quality and blood donors–a marketing perspective. J Mark Managt 13(6), 579–599 (1997)CrossRefGoogle Scholar
- 37.Nonis, S.A., Ford, C.W., Logan, L., Hudson, G.: College student’s blood donation behavior: relationships to demographics, perceived risk, and incentives. Health Mark. Q 13(4), 33–46 (1996)CrossRefPubMedGoogle Scholar
- 38.Tscheulin, D.K., Lindenmeier, J.: The willingness to donate blood: an empirical analysis of socio-demographic and motivation-related determinants. Health Serv Manage Res: an official journal of the Association of University Programs in Health Administration/HSMC, AUPHA 18(3), 165–174 (2005)CrossRefGoogle Scholar
- 39.Duboz, P., Cuneo, B.: How barriers to blood donation differ between lapsed donors and non-donors in France. Transfus Med 20(4), 227–236 (2010)CrossRefPubMedGoogle Scholar
- 40.Oswalt, R.M., Hoff, T.E.: The motivations of blood donors and nondonors: a community survey. Transfusion 15(1), 68–72 (1975)CrossRefPubMedGoogle Scholar
- 41.Burnett, J.J., Leigh, J.H.: Distinguishing characteristics of blood donor segments defined in terms of donation frequency. J Health Care Mark 6(2), 38–48 (1986)PubMedGoogle Scholar
- 42.Silverman, B.W.: Density estimation for statistics and data analysis. Chapman & Hall, London (1986)CrossRefGoogle Scholar
- 43.Priller, E., Schupp, J.: Soziale und ökonomische Merkmale von Geld- und Blutspendern in Deutschland. DIW Wochenbericht 78(29), 3–10 (2011)Google Scholar
- 44.Shehu, E., Langmaack, A.-C., Felchle, E. and Clement, M.: Profiling donors of blood, money and time: a simultaneous comparison of the German population, Nonprofit Management & Leadership, forthcomingGoogle Scholar
- 45.Sianesi, B.: An evaluation of Swedish system of active labour market programmes in the 1990s. Rev Econ Stat 86(1), 133–155 (2004)CrossRefGoogle Scholar
- 46.Black, D., Smith, J.: How robust is the evidence on the effects of college quality? Evidence from matching. J Econom 121, 99–124 (2004)CrossRefGoogle Scholar
- 47.Lechner, M.: Some practical issues in the evaluation of heterogeneous labour market programmes by matching methods. J R Stat Soc A 165, 59–82 (2002)CrossRefGoogle Scholar
- 48.Rosenbaum, P.R.: Observational studies. Springer, New York (2002)CrossRefGoogle Scholar