The European Journal of Health Economics

, Volume 16, Issue 7, pp 733–745 | Cite as

Healthy donor effect and satisfaction with health

The role of selection effects related to blood donation behavior
  • Edlira ShehuEmail author
  • Annette Hofmann
  • Michel Clement
  • Ann-Christin Langmaack
Original Paper


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.


Propensity score matching Blood donation services Socio-economic panel Donor management 

JEL Classification

I12 C83 C21 I14 

Supplementary material

10198_2014_625_MOESM1_ESM.docx (395 kb)
Supplementary material 1 (DOCX 394 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Edlira Shehu
    • 1
    Email author
  • Annette Hofmann
    • 2
  • Michel Clement
    • 1
  • Ann-Christin Langmaack
    • 1
  1. 1.Institute for Marketing and Research Center for Health MarketingUniversity of HamburgHamburgGermany
  2. 2.Hamburg Institute for Risk and InsuranceHSBA Hamburg School of Business AdministrationHamburgGermany

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