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Blood donation as a public good: an empirical investigation of the free rider problem

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Abstract

A voluntary blood donation system can be seen as a public good. People can take advantage without contributing and have a free ride. We empirically analyse the extent of free riding and its determinants. Interviews of the general public in Spain (n = 1,211) were used to ask whether respondents were (or have been) regular blood donors and, if not, the reason. Free riders are defined as those who are medically capable to donate blood but do not. In addition, we distinguish four different types of free riding depending on the reason given for not donating. Binomial and multinomial logit models estimate the effect of individual characteristics on the propensity to free ride and the likelihood of the free rider types. Amongst those who are able to donate, there is a 67 % probability of being a free rider. The most likely free rider is female, single, with low/no education and abstained from voting in a recent national election. Gender, age, religious practice, political participation and regional income explain the type of free rider.

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Notes

  1. In the year of our survey, 2004, the donation index (no. of donations per 1,000 population) was 39.6 [23], which is around the average donation rate for developed countries (38.1) [24].

  2. It is therefore a lifelong definition of free rider.

  3. The respondent was also given the option of specifying “other reason” but this was omitted from the analysis since only five respondents (0.5 % of those who do not donate) chose this.

  4. We are grateful to one of the referees for providing this idea.

  5. The MNLM assumes independence of irrelevant alternatives (IIA); see Long and Freese [29]. We test for its appropriateness using the Hausman and Small-Hsiao tests by first estimating the model with all of the four reasons for free riding and subsequently re-estimating it by dropping one of the reasons. This is then followed by the tests for IIA. If IIA is violated, an alternative model should be considered (such as the nested multinomial logit or the multinomial probit model) that relaxes the IIA property. In addition, a Wald test is conducted to explore whether or not combining some of the response categories would make the model more efficient.

  6. We are grateful to one of the referees for pointing this out.

  7. The proportion of donors who are (or have been) a regular blood donor seen in our study is close to the proportion of individuals who have ever given blood in Spain (24 %) reported in Healy [14].

  8. We are thankful to one of the referees for providing this idea.

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Acknowledgments

The authors are grateful to Juan Diez-Nicolas and all the respondents who agreed to take part in the survey, and also to the Spanish Instituto de Estudios Fiscales for financial support to undertake this research. We would also thank to Paula Lorgelly for her discussion of a previous version of this article at the July 2009 Health Economists’ Study Group conference and participants at the XXIX Jornadas de Economía de la Salud in June 2009 for their comments. Special thanks are due to Tony Culyer for his encouragement. We are also grateful to José Cáceres, Victor Cano, Andrew Dickerson, Beatriz González, Jeffrey Harris, Arne Risa Hole, Miguel A. Negrin, Jaime Pinilla, Carolina Rodríguez, Peter Wright and the two anonymous referees from EJHE for their comments. The usual disclaimers apply.

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  1. Departamento de Economía de las Instituciones, Estadística Económica y Econometría, Facultad de Ciencias Económicas y Empresariales, Universidad de La Laguna, Campus de Guajara, 38071, La Laguna, Tenerife, Spain

    Ignacio Abásolo

  2. Department of Economics and School of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, UK

    Aki Tsuchiya

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  1. Ignacio Abásolo
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Correspondence to Ignacio Abásolo.

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Abásolo, I., Tsuchiya, A. Blood donation as a public good: an empirical investigation of the free rider problem. Eur J Health Econ 15, 313–321 (2014). https://doi.org/10.1007/s10198-013-0496-x

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