Exploring resource allocation and alternate clinic accessibility landscapes for improved blood donor turnout

An important goal for blood agencies, especially in the context of aging populations, is to ensure the sufficiency of the blood supply. Of the eligible population, only a small proportion donates. A question therefore is how to expand the donor base. Previous research has shown that accessibility to clinics positively associates with donor turnout. Since accessibility depends on the allocation of resources to clinic sites it provides a policy handle to facilitate donor participation. Generation and examination of clinic accessibility landscapes can be part of a strategy to increase donor turnout. The research uses donor and clinic databases provided by Canadian Blood Services for calendar year 2008. Donor numbers were aggregated at the level of Dissemination Areas for the city of Toronto, Canada, and complemented with socio-economic and demographic information from the Census. Multivariate statistical analysis confirms the positive association between number of donors and accessibility, calculated using a two-step floating approach. The model becomes the objective function in a heuristic search procedure (genetic algorithms) to investigate the potential effect on donor turnout of allocation of resources to clinics. The results of the analysis indicate that the current number of donors is at the lower end of the range of solutions obtained from generating accessibility landscapes. Gains in the total number of estimated donors range between 1% and 22%. An advantage of generating several solutions is the possibility of examining the magnitude of change required, in terms of the (re-)allocation of resources to clinics. Detailed examination of the results can assist decision-makers to evaluate the trade-offs between the magnitude of the change required and the potential payoff. Given current trends, there is a need for planning to ensure that the supply of blood is sufficient. Even small gains can make an important difference between a sufficient blood supply and shortages. The approach presented here to generate clinic accessibility landscapes constitutes a useful tool for blood agencies to explore scenarios for increasing their donor base.