Marketing management in blood service enterprises

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Marketing management in blood service enterprises

Liliia Khomenko, PhD student, Yurii Rymar, PhD student, Department of Marketing, Sumy State University

Abstract

In blood service, the volume of collected blood components depends on availability of donors. High demands require high product quality (safety, etc.). Blood component quality depends on the state of donors health. Storage periods of blood components are limited and require certain conditions. Blood service enterprises should be located within the reach of patients, and mostly in big cities with a large population. The quality and quantity of collected blood are affected by the level of morbidity, which leads to the withdrawal of donors and losses to blood service enterprises. Consequently, the blood centre performance largely depends on success of marketing activities: number of donors and recruitment campaigns. Simultaneously, blood donation by volunteers is possible only thanks to successful and systematic advertising about the benefits of donation for health.

Maintenance of a suitable health state depends on retention campaigns and establishment of long-term relations between blood centres and donors via direct marketing. Sales promotion measures force people to donate blood, for the first time and make it a stable habit to visit a blood centre every month. The safest blood is from a regular donor, and retention marketing helps convert a primary donor into a regular one. The article carries out a bibliometric analysis of Web of Science works for 1991-2023 that are devoted to marketing at blood service enterprises. The analysis proved some facts. Firstly, the blood service topic requires studing further (there are only 304 works). Secondly, we see a growth of research interest (32.5% of all works for 2019-2023) and an almost double increase in annual citations from 2019. Thirdly, scientists from the United States, Germany, Australia, England, France, and Spain lead in such studies. The article summarises problems of the Ukrainian blood service. They can be solved with marketing management (safety, managerial, informational, economic).

The paper defines goals and objectives, main stages and principles of marketing management for blood service enterprises. A system of 20 criteria for evaluating the efficiency of marketing management measures at blood service enterprises has been developed. The research results form a basis for the general idea of marketing management in blood service enterprises.

Keywords: marketing management; blood service; marketing activities; management mechanism; donor; blood component; efficiency criteria; bibliometric analysis .

Introduction

There are many aspects of blood service enterprises that are related to marketing:

• Number of donors, collected blood, and blood components (plasma, erythrocytes, platelets) depend on success of recruitment campaign;

• Blood donation by volunteers is possible only thanks to successful and systematic advertising campaigns about the benefits of donation for health;

• Maintenance of a health suitable state depends on retention campaigns and establishment of longterm relations between blood centres and donors via direct marketing;

• Sales promotion stimulates people to donate blood for the first time and make a stable habit of visiting the blood centre every month;

• The safest blood is from a regular donor, and retention marketing helps convert a primary donor into a regular one.

The marketing activity of blood service enterprises allows them to attract and retain a required number of people to the donor movement. Consequenlty, a necessary amount of blood and its components are collected from them.

Countries that actively use marketing achievements in blood centres fully satisfy needs of their region. According to the WHO (2022), in 60 countries, volunteer donors ensure 100% of blood supplies. They do this thanks to effective marketing programs.

In 2015, Great Britain conducted the Missing Type advertising campaign. To encourage new blood donors, hundreds of organisations have removed the letters “A”, “B” and “O” from their banners in social networks to draw attention to the “missing types” of blood donors. Campaign participants included famous international companies. The campaign attracted more than 30,000 new applications from potential donors in its first month. The campaign was so successful that many blood centres around the world joined the follow-up campaign in the following years (NHSBT, 2019).

Back in 2008, Cristiano Ronaldo became the face of an advertising campaign for donations. To this day, he cooperates with Associazione Volontari Italiani Sangue (AVIS). It promotes blood donation in Italy. During this time, a huge number of joint advertising campaigns were implemented (AllFootballApp, 2023). Such an activity also contributed to the fact that every Italian believes being a donor is a very honourable thing. In 2018, Ronaldo started supporting blood donation with the Singapore Red Cross (the Be The 1 movement).

For several years now, blood banks in Sweden have been sending donors a “thank you” message every time their blood rescues someone's life. Donors are happy to share such messages on social networks, thanks to which the campaign has gone viral. Another well -known Swedish campaign is “Nag me until I become a blood donor”. In Sweden, everyone who is thinking about becoming a donor has an opportunity to leave their phone number. He receives a message every time the bank needs blood. Until now, on days when banks do not need blood, all subscribers of the program receive a message with the text “We will not give up until you bleed” (Upworthy, 2023).

In Ukraine, the number of donors and collected blood for 2012-2021 decreased by half, donations - by 1,5 times, plasma - by 15%. Besides, 70% of Ukrainian donors donated blood only once in their life. At the same time, the demand for blood and its components is constant . It grows every year. Requirements for blood safety and quality are rising worldwide. This trend hurts the quality and availability of medical care. Although in the first days of the Russian invasion more people were willing to donate blood than the blood centres could accept, after a few months there were announcements on the blood centre's Internet platforms about the lack of blood and need for donors.

Locally, the Ukrainian blood service is represented by blood centres in each region. Their main tasks are to provide medical institutions with components and preparations of donor blood; to provide services for medical examination and registration of donors; to collect and process blood and its components; to test, store and transport blood and its components, etc. They can also produce blood plasma preparations; control the use of components and preparations of donor blood; organise the donation promotion among the broad strata in regions, etc. That is, they function as medium and small production enterprises with a sales market.

In many countries, blood centres deal only with examination, collection, processing, storage, transportation, neutralisation and distribution of donor blood and its components. Meanwhile, the Red Cross, donation associations, etc. procure donors and promote ideas of the blood donation volunteering.

In Ukraine until the 1980s-1990s, there was a powerful centralised promotion of donation, which contributed to the blood service development. Over time, state support for the donor movement was canceled, free donation decreased, methods of donors' encouraging were lost. It led to a rapid reduction in both the number of donors and the volume of collected blood and its components. Currently in Ukraine, each blood centre promotes the blood donation idea on its own, without relying on significant support from the state. As a result, the Ukrainian blood service develops unevenly: in some regions this activity is unsystematic and not so large-scale. Thus, the number of donors ranged from 3711 to 31734 people per region. The total number of local donations was from 5590 to 106089. The number of donations per thousand population ranged from 4.83 to 102.64. As a result, there was a rapid decline in the industry (Perekhrestenko et al., 2023).

The Ukrainian blood service, which plays a strategic role in national security, is represented in 2021 by 29 blood centres (small and medium enterprises) and 204 blood banks (at hospitals). Only the Biopharma processing plant, and suppliers of equipment and consumables are representatives of big business in this field.

There are other approaches to the blood service organisation. In Italy, 21 regional blood centres coordinate the activity of respective local blood establishments network. Blood centres collect blood and its components, process, test, storage, and distribute them. Most establishments also work as blood banks in hospitals. Promotion of voluntary donations depends on public organisations, such as AVIS, FIDAS, FRATRES, CRI, etc. (EBA, 2024).

There are four blood services in the UK: England (NHSBT), Scotland (SNBTS), Wales (WBS) and Northern Ireland (NIBTS). They are subordinate to the UK Ministry of Healthcare. Each of the blood services conducts its national advertising campaigns to attract new and work with existing donors (EBA, 2024).

More than 50 blood centres operate in Japan while the system of blood collection and production of its components and drugs is managed by the Red Cross. The Red Cross, together with the government and regional authorities at the state level, organises a voluntary non -remunerated donation movement to guarantee a constant supply of blood products sufficient to provide medical care to patients. At the same time, regional governments are forming plans for blood collection. The Blood Donation Promotion Council is established in each prefecture under governors. Representatives of various organisations form groups of donors and recruit individuals. Blood centres cooperate with the Blood Donation Promotion Council in each region. They hold seminars and explanatory lectures on the blood donation promotion (EBA, 2024).

In Germany, the blood service functioning is provided by four organisations: the blood transfusion service of the German Red Cross; state and communal blood transfusion services; commercial blood centres; plasmapheresis centres of the plasma fractionation industry. In total, there are 70 blood centres in Germany (19 independent and 51 hospital-based). The German Red Cross has seven blood transfusion services, including 28 donor centres and institutes (EBA, 2024).

Peculiarities of blood service enterprises are that the volume of procured blood components depends on availability of donors. High demands are placed on product quality (safety, etc.). Blood quality depends on the donors' health state. Storage periods of blood components are limited and require certain conditions. The blood service facility should be located within the reach of patients (usually, in cities with a large population). Quality and quantity of collected blood are affected by the morbidity rate. It leads to the diversion of donors and losses to blood service enterprises.

The viability of blood service enterprises, like any other industry, mainly depends on management, including marketing management, which should be based on modern achievements of science. Marketing strategy is not the only functional strategy of the company . It plays a significant role in the long-term perspective (Savina, 2018). Additionally, the WHO and EU strategies for the blood quality and safety pay a considerable attention to the blood service marketing (WHO, 2022).

Since the provision of blood components is a priority country task, especially during the war, the issue of effective marketing management in blood service enterprises is relevant today. Therefore, there is a need to form a mechanism for marketing management in blood service enterprises.

There are many publications on the marketing management for small and medium enterprises. However, the theme of marketing management in blood service enterprises is not covered in publications.

Literature review

Various aspects of activities of blood service enterprises are presented in works of scientists.

Aravindakshan et al. (2015) developed a marketing cost management model for blood banks. Because most blood banks in the United States are public non-profit organisations and have limited marketing budgets, they use three types of media: paid, owned, and earned (POE) media. The authors describe the rules for allocating advertising resources for blood banks and show when traditional recommendations for budget allocation do not apply. They found that in certain situations, earned media activity hurts the blood bank performance, even though it is mostly free.

Kauten et al. (2021) studied the use of modern machine learning algorithms for modeling donor retention. Acording to the data from a US blood centre, the authors built a donor retention model with a Matthews correlation coefficient of 0.851. This model of donor retention makes it possible to develop costeffective programs for working with donors.

Zhu et al. (2023) developed a model to optimise donor incentive schemes by accounting for both the blood centre's stock level and random demand, perishable blood and blood components, the observation period between donations, and the variability of donor recruitment and dropouts. This leads to reduction in shortages and wastage. The model allows to determine the optimal number of donors. It takes into account that donors have different sensitivity to donations and require different encouragement.

Pereira et al. (2019) analysed how the Brazilian government programs of blood donation are perceived by different types of people: donors, non-donors, and potential donors. Most often, government campaigns are conducted not to change people's behaviour but rather as an emergency acting to cancel shortages in blood banks. Besides, there has been instability in the government 's blood donation strategies, which contradicts the educational propositions present in social marketing theory.

Many scientists pay attention to establishing long -term relationships with regular donors. Thus, Sardi et al. (2017) investigated the elements of mobile gamification to retain donors, primarily among young people. However, most mobile blood donation applications are not multi-lingual and have social logins and traditional authentication methods. Most apps are multi -purpose: they help users find donors and blood centres, track the dates of future records to the centre, and check their ability to donate. Most installed apps include notification features. They also can notify users of nearby donation needs with built -in geolocation services. The most common elements of gamification are badges and points that can be exchanged. At the same time, there is a need for better incentives to attract potential donors to donate blood.

Martin-Santana et al. (2021) raises the question of increasing the satisfaction and loyalty of active donors. The strategy essence is to create comfortable conditions for donation that the donor is very satisfied with. This is done to support donors' intentions to donate blood again and to spread positive recommendations about donation among other people who could become donors in future. At the heart of this approach is the focus on donor and quality of services (primarily, safety).

Shehu et al. (2023) analysed strategies of improving relations with donors. He proposed a new strategy based on sending information about the use of previous donations. As a result, it increases donor's loyalty to the blood centre. It helps to keep donors, especially more experienced donors. It is also important that these messages are sent soon after the donation. Such appeals help to increase the rate of inactive donor retention.

Strategies for the transfer of blood donors into plasma donors to increase the frequency of donations were considered by Saltzmann (2023). This strategy is based on two mechanisms: awareness of need for plasma donation (donors are informed that patients need not only blood but also plasma) and perception of donors' response efficacy (understanding that donated plasma helps other people). Despite a weak desire to start donating plasma instead of blood, 31% of participants can join receiving additional information on this issue. A personalised appeal is effective. It contains information about the fact that the plasma of this particular donor can rescue someone's life. That is, to convert a blood donor into a plasma donor, he must first learn a need for plasma. Then, through additional interaction, face-to-face conversations, the donor realises that his plasma can rescue other people.

At the same time, it is a problem for many blood centres to attract a sufficient number of donors to the donor movement. For example, Gilbert et al. (2019) examined engagement campaigns through infection testing and effectiveness of print or video ads, news website ads, app ads, etc. To track the results, an access code unique to the media and linked to the account was used. The highest rate of account creation is seen among individuals who came through online advertising (although a much lower proportion of people went on to test). Advertising on physical sites was proven to be important and cost -effective because it had the lowest cost. This approach allows you to evaluate the effectiveness and economic efficiency of various advertising activities.

Also, researchers focus on donors' behaviour. Thus, Wang et al. (2021) investigated the social information efficiency in changing the wishes of voluntary blood donation before and after the COVID-19 peak in China. Two messages were compared: thanking the donor and informing them about the patient's need for blood. It has been confirmed that in contrast to information about praise of blood donors, data about the demand of blood consumers has a stronger motivating effect on a person's intention to donate blood. The source of information must be official. Social information strongly effects on a person's intention to donate blood. The COVID-19 context does not show a significant impact on blood donation intentions.

Goette & Stutzer (2020) studied the influence of material rewards on donation. The authors found that, on average, a lottery ticket offer increased the likelihood of donating blood by 5.6 percentage points compared to a baseline of 46%. At the same time, this effect is manifested among less motivated donors. There is no decrease in donations over time.

Rodrigues et al. (2020) explored personality factors determining the donor's behaviour. The authors concluded the personality of non-donors is very different from potential donors. That is, potential donors may perceive blood donation and related barriers differently than non -donors.

The issue of improving the quality of blood components and their safety is also subject to detailed study. Nagurney & Dutta (2019) investigated competition in the US blood market and its impact on improving service quality. The developed model of the competitive network for blood donation determines the conditions of Nash equilibrium and provides the formulation of the variational inequality. It is established that the equilibrium model of blood service organisations is guaranteed to exist and provides conditions for the uniqueness of the solution. At the same time, the authors focus on the blood service quality, not on the quality of blood products. Competition between non-profit organisations also needs to be accounted for.

Martin-Santana et al. (2021) and Romero-Dominguez et al. (2022) studied the influence of sociodemographic and donor behaviour characteristics on motivation of donor behaviour as well as barriers to donation (Martin-Santana et al., 2020). People aged from 18 to 35 that have high education and high income are more frequently restrained by donation barriers. At the same time, people who have few donate experience (once or twice a year or less) are more exposed to donation obstacles. The biggest barriers are informational and time-space. Women prove to experience more internal barriers, and men are more restrained by external ones. Young people between the ages of 18 and 35 are most restrained by barriers but they decrease with age. For people with higher education and income, time barriers are most often. Donors with fewer donate experience have the least level of awareness and the most time and space constraints. On the contrary, those who donate blood the longest face the fewest barriers. The biggest barrier is among young people who study at university and rarely donate blood. However, they are of most interest to blood centres because of the nation aging. Therefore, blood centres need to focus their marketing campaigns on informational and procedural barriers. Also, blood centres need to analyse which donate barriers are the most common in their donor's base. They should determine the most important characteristics of these donors (in particular, socio-demographic). Based on these data, they can develop marketing campaign to decrease those barriers because of which people do not donate blood again.

Among the Ukrainian authors, there are several studies devoted to quality management in blood service enterprises. Such researchers are Liubchak et al. (2017) and Liubchak et al. (2021). The authors have developed a methodology for calculating the regional donor capacity. It allows the blood centre to determine the real number of potential donors that can be attracted through marketing campaigns. The developed methodology for calculating the cost of blood service allows them to account for both the blood centre's costs and those received through state programs. They also developed a mechanism for creating a blood centre by international standards based on the existing infrastructure. Moreover, the authors provided recommendations for creating an interregional plasma storage centre.

Perekhrestenko et al. (2023) conducted the blood service market analysis. It allows managers of regional blood centres to plan the collection volume of blood and its components.

Methodology, theory and conceptual framework

This study assesses the marketing management mechanisms in blood service enterprises.

The main focus of this study is a bibliometric analysis of literature sources about marketing management in blood service enterprises. Bibliometric analysis is based on quantity analysis of bibliographic documents. It allows to reveal trends and regularities within the researched issue.

Firstly, we provide sample forms based on the scientometric database by keywords. Such keywords for this study were “marketing management” and “blood donation”. The selection was made by keywords in the topic.

As a search result, 2,756 publications were found.

Next, the data is filtered by parameters (types of documents, language of documents, year, etc.).

Only research and review articles, proceeding papers were included in the sample. All works were published during 1991-2023. All of them are printed in English.

Thus, only 304 of the most relevant publications were included in the sample.

First, the dynamics of publications in terms of the number of works and the number of citations is studied. The increase in the number of publications and citations indicates the growing scientific interest in this topic.

Next, affiliations with the largest number of publications on the selected topic are determined. The absence of affiliations with a large number of publications indicates that there are no scientific schools on this topic. If there are affiliates with a large number of publications, they systematically study this issue.

The countries whose authors have published the most works on this topic are determined. This shows the authors of which countries make the greatest contribution to the development of this direction.

Authors who have the largest number of publications on the chosen topic are also defined. The study identified ten authors who published at least four papers. This may indicate the influence of these researchers in this field.

The paper detected five largest publishers in which the works were printed. Each has at least 12 works. Journals with the largest number of publications and how many citations these works have together are also determined.

Five most cited works on the topic have been identified. Their publication dates, number of citations, and average number of citations per year are compared.

Based on comparison of the number of publications and citations, it is possible to draw a conclusion about the influence of affiliation data, publishers, magazines, authors, and countries on the selected topic.

The next stage is to analyse keywords in the publications. This allows to study and identify clusters in publications on marketing management of blood service institutions.

Via the visualisation map of publications by level of semantic proximity and year of their activation, a conclusion is made about the periods in which the activation of studies took place and how their subject matter changed.

Next, a visualisation map with directions of research on marketing management in blood service enterprises in 1991-2023 is built.

After that, links among research keywords are built. The hierarchical cluster analysis is used to understand subdomains of research on marketing management in blood service enterprises. Cluster analysis of publication trends is carried out using the VOSviewer software (2024).

The visualisation map allows to see which directions of research prevail (the largest circle size means the most often research) and the connections between research topics. The map makes it possible to see research clusters. Next, keywords that are characteristic of each cluster are defined.

By comparing the visualisation map by regions and in general, you can see which clusters appeared earlier, which are the newest. Such an analysis makes it possible to see the main groups of research directions on the chosen topic.

In order to understand the topics of current research and predict the future, a similar map is being built based on data for the last five years - 2019-2023. It gives an opportunity to see what new directions of research are emerging and to predict the current topics of research for the coming years.

The work summarises problems of the Ukrainian blood service. It can be solved via marketing management. That defines the goals, tasks, main stages, and principles of marketing management in blood service enterprises.

A system of criteria for evaluating the performance of marketing management measures in blood service enterprises has been developed. Also, a sequence of stages is implemented for this.

A marketing management mechanism in blood service enterprises has been developed.

Results

According to the Web of Science database 2 ,756 publications (articles, review articles, and proceeding papers) published during 1991-2023 in English are devoted to medical marketing. At the same time, only 304 publications are devoted to marketing management in blood service (Figure 1). The studied sample is based on the Web of Science data using the keywords “marketing management” AND “blood donation” OR “blood donor”.

Among them, there are 243 articles, 46 review articles, and 23 proceeding papers. 32.5 % of all publications were printed during 2020-2023. It indicates the relevance of this topic.

The increase in publications and citations of Figure 1 demonstrates a growing interest to the topic.

Figure 1. Times cited and publications over time

Source: Based on Web of Science (2024)

Most research is conducted in the areas of Hematology (78 publications), Business Economics (52 publications), Immunology (25 publications), Public Environmental Occupational Health (18 publications), Engineering (16 publications), Pharmacology (16 publications), Biotechnology and Applied Microbiology (14 publications). Institutions with the largest number of publications by their affiliation are represented in Table 1.

Table 1. Affiliations with five and more publications on marketing management in blood service enterprises