How Public Trust and Healthcare Quality Shape Blood Donation Behavior: Comparative Evidence

Blood donors are indispensable for enabling a myriad of medical procedures and treatments. Although blood donation takes place in a medical setting within the larger healthcare system, little is known about how (perceptions of) these healthcare systems shape an individual’s decision to donate. In this study, we examined how public trust in the healthcare system and indicators of healthcare quality relate to individuals' likelihood of donating blood across Europe. We employed large-scale survey data on blood donation behavior from representative samples of 28 European countries (N = 27,868). This dataset was combined with country-level data on public trust in the healthcare system and healthcare quality. We used multilevel models to examine the effects of individual- and country-level factors on individual-level blood donation behavior. Our preregistered analyses revealed that public trust was positively associated with donating blood. That is, individuals living in countries where trust in the healthcare system is higher were more likely to have donated blood. However, we found no clear evidence that healthcare quality predicted blood donation. Notably, most countries exhibited a decrease in public trust in the healthcare system while healthcare quality increased over time. Our results suggest that subjective perceptions of the healthcare system (i.e., public trust), rather than the objective state of healthcare, play a role for blood donation behavior. We highlight the implications of our findings for vital blood collection efforts in light of the observed erosion of public trust over time.