中国输血杂志2026，Vol.39Issue(6)：699-710,12.DOI:10.13303/j.cjbt.issn.1004-549x.2026.06.001
基于系统视角的血液管理体系:从地区血液供应到临床输血决策的整合模型构建
A blood management system from a systemic perspective:development of an integrated model from regional blood supply to clinical transfusion decision-making
摘要
Abstract
Objective To address systemic challenges in the blood system,such as supply-demand imbalance,ineffi-cient allocation,and inappropriate clinical use,while bridging gaps in current theories regarding the integration of social mobilization,institutional practice,and policy coordination.It sought to construct a system dynamics model spanning from macro to micro levels to analyze the blood management system holistically.Methods Key variables were identified by a systematic literature search in both Chinese and English databases.An improved Delphi method was then employed to con-duct expert consultations across different fields,leading to the selection and determination of core variable sets for each sub-model.Furthermore,by defining their logical relationships,a system dynamics model was constructed to systematically ana-lyze the operation mechanism of the blood management system.Results Four core sub-models were developed:1)A macro"Dynamic Balance"model quantifying regional supply-demand equilibrium and inventory control;2)a mobilization"Three-Layer Funnel"model analyzing how socio-cultural factors,service channels,and policy incentives influence donation behav-ior;3)an institutional"Dual-Cycle Regulation"model revealing hospital blood usage is driven by both disease burden(de-mand cycle)and management practices(regulation cycle);and 4)an individual"Three-Layer Filter"model standardizing clinical transfusion decisions based on necessity,risk-benefit,and context.These were integrated into a"Multi-Layer Link-age and Feedback"model,elucidating bidirectional interactions among five levels:policy environment,regional supply,blood station mobilization,hospital application,and clinical decision-making.Conclusion This study constructed a system dynamics model for blood management.By defining key variables and their logical relationships,it systematically analyzes the system's operational mechanism.The integrated framework connects multiple levels—regional supply,voluntary dona-tion,hospital blood use,and clinical decision-making—revealing their intrinsic linkages.Future efforts should employ sys-tems thinking to synergistically enhance supply-side mobilization,demand-side management,systemic regulation,and deci-sion standardization to build a safe,efficient,and sustainable blood security system.关键词
血液管理/血液供应/无偿献血/临床用血/输血决策/模型Key words
blood management/blood supply/voluntary blood donation/clinical blood use/transfusion decision-mak-ing/model分类
医药卫生引用本文复制引用
朱长太,孙蕴华,张兰珺,黄龙,黎勤云,唐河山,臧艳,林俊杰,钱宝华..基于系统视角的血液管理体系:从地区血液供应到临床输血决策的整合模型构建[J].中国输血杂志,2026,39(6):699-710,12.基金项目
上海市卫健委2025年卫生健康政策研究课题项目(2025HP42) （2025HP42）
