Blood Supply and Demand in Korea: What is in Store for the Future?

PURPOSE: Presently, Korea is facing new challenges associated with an imbalance in blood supply and demand. The purpose of this study was to examine trends in blood supply and demand in Korea over the past 10 years through 2018 and to propose what to prepare in the future. MATERIALS AND METHODS: Age demographics in Korea were analyzed using data from the Statistics Korea. Blood donation and blood supply data were analyzed using Blood Services Statistics 2018 by the Korean Red Cross. Blood transfusion data from hospitals in 2018 were obtained from the Health Insurance Review and Assessment Service. RESULTS: In 2018, 2883270 whole blood and apheresis units were collected in Korea. The Korean Red Cross supplied 4277762 blood components to 2491 hospitals. The overall blood donation rate was 5.6%, and the most frequent donors were young male donors. Leukoreduced red blood cells (RBCs) constituted 25% of all RBCs used, and 40% of all platelets were supplied by single-donor platelets. The self-sufficiency rate of domestic plasma with which to produce plasma-derived medicinal products was 68.7% in 2018. Blood use was the most frequent among patients aged 70-79 years. CONCLUSION: Blood management in Korea is changing rapidly due to a low birth rate, rapid aging, and an increase in severely ill patients who require most of the blood supply. Therefore, future plans to promote donation at a national level and optimal use of blood in hospitals is necessary.

Korean Red Cross Hospital (1905-1907): Focused on its Establishment, Management and Abolition.

The Korean Empire, its state sovereignty threatened by the Empire of Japan, joined the Geneva Conventions in 1903 for the purpose of neutral diplomacy and established the imperial Korean Red Cross Hospital in 1905. This hospital was a result of the effort of the Korean Empire to seek a new medical system based on the Western medicine. However, after the Russo-Japanese War, Japan interfered straightforwardly in the domestic affairs of Korea and eventually abolished the Korean Red Cross Hospital in 1907 to create Daehan Hospital under Japanese colonial rule. With newly-found historical records, this study investigates the whole process of the Korean Red Cross Hospital, which has remained unknown so far, despite its importance. From the very beginning, the Korean Red Cross Hospital was under strong influence of the Empire of Japan. The site for the hospital was chosen by a Japanese army doctor, Junryo Yoshimoto, and the construction was supervised by Rokuro Katsumata, who also later on are involved in the construction of Daehan Hospital. Moreover, all the main positions for medical treatments were held by Japanese practitioners such as Goro Tatami and Kaneko Yano. Nevertheless, the Korean government had to shoulder the all operating costs. The office of the Korean Red Cross was relocated away from the Korean Red Cross Hospital, and the government of the Korean Empire was not willing to burden the expenses of the Hospital. Moreover, the list of employees of the Korean Red Cross and that of the Korean Red Cross Hospital were drawn up separately: the former is left only in Korea and the latter in Japan. These facts suggest that those two institutes were managed dualistically unlike any other nation, implying that this may have been a means to support the Daehan Hospital project. According to the statistics, health care services in the Korean Red Cross Hospital seems to have been carried out successfully. There had been an increase in the number of patients, and the ratio of female patients was relatively high (26.4%). Only Western medications were prescribed and surgical operations with anesthesia were performed routinely. The approach to Western medicine in Korea was changing during that period. The rise and fall of the Korean Red Cross Hospital represent the urgent situation of the Korean Empire as well as the imperialistic methodology of the Empire of Japan to use medicine as a tool for colonization. Although the transition process of medical policy by the Japanese Resident-General of Korea still remains to be fully elucidated, this paper contributes to a better understanding of the history of modern medicine in Korea.

Korean Red Cross Hospital (1905–1907): Focused on its Establishment, Management and Abolition / 의사학

The Korean Empire, its state sovereignty threatened by the Empire of Japan, joined the Geneva Conventions in 1903 for the purpose of neutral diplomacy and established the imperial Korean Red Cross Hospital in 1905. This hospital was a result of the effort of the Korean Empire to seek a new medical system based on the Western medicine. However, after the Russo-Japanese War, Japan interfered straightforwardly in the domestic affairs of Korea and eventually abolished the Korean Red Cross Hospital in 1907 to create Daehan Hospital under Japanese colonial rule. With newly-found historical records, this study investigates the whole process of the Korean Red Cross Hospital, which has remained unknown so far, despite its importance. From the very beginning, the Korean Red Cross Hospital was under strong influence of the Empire of Japan. The site for the hospital was chosen by a Japanese army doctor, Junryō Yoshimoto, and the construction was supervised by Rokurō Katsumata, who also later on are involved in the construction of Daehan Hospital. Moreover, all the main positions for medical treatments were held by Japanese practitioners such as Gorō Tatami and Kaneko Yano. Nevertheless, the Korean government had to shoulder the all operating costs. The office of the Korean Red Cross was relocated away from the Korean Red Cross Hospital, and the government of the Korean Empire was not willing to burden the expenses of the Hospital. Moreover, the list of employees of the Korean Red Cross and that of the Korean Red Cross Hospital were drawn up separately: the former is left only in Korea and the latter in Japan. These facts suggest that those two institutes were managed dualistically unlike any other nation, implying that this may have been a means to support the Daehan Hospital project. According to the statistics, health care services in the Korean Red Cross Hospital seems to have been carried out successfully. There had been an increase in the number of patients, and the ratio of female patients was relatively high (26.4%). Only Western medications were prescribed and surgical operations with anesthesia were performed routinely. The approach to Western medicine in Korea was changing during that period. The rise and fall of the Korean Red Cross Hospital represent the urgent situation of the Korean Empire as well as the imperialistic methodology of the Empire of Japan to use medicine as a tool for colonization. Although the transition process of medical policy by the Japanese Resident-General of Korea still remains to be fully elucidated, this paper contributes to a better understanding of the history of modern medicine in Korea.

Analysis Survey on Changes in Hospital Blood Donation Center and Satisfaction Level with the Korean Red Cross / 대한수혈학회지

BACKGROUND: Blood supply circumstances in Korea have changed in recent decades because of blood supplier diversification and restructuring of hospital blood donation centers. The purpose of this study is to understand the current status of hospital blood donation centers and their satisfaction levels with the Korean Red Cross Blood Center (KRCBC) and compare with the previous results for sustainable development of the blood supply system. METHODS: During one month in November 2014, we conducted a questionnaire survey through e-mail in 64 hospital blood donation centers which are approved by government. The response rate was 97% (62/64 hospitals). Responses from 62 hospitals were analyzed. RESULTS: The number of hospital blood donation centers were reduced by half from 129 in 2004 to 64 in 2014. There was no blood donation center in hospitals less than 400 beds, except 2 hospitals; 23 hospital (37.1%) blood banks collected no blood components. More than 80% of hospitals were satisfied with the KRCBC service such as donor record lookup and nucleic acid amplification Test (NAT) results lookup. Hospitals with more than 1,000 beds replied that they would not take account of transferring the collection services to KRCBC because of the directed and autologous donation and unexpected emergency blood transfusion. CONCLUSION: The government should be the subject of national blood policy and establish a committee or agency for its comprehensive and consistent execution through close cooperation with the KRCBC and hospitals.

Analysis of Present Status as Blood Donation Center of Hospital Blood Banks and Satisfaction Level with the Korean Red Cross / 대한수혈학회지

BACKGROUND: Blood supply in Korea has been unstable in more than a year because transfusion-related infection was repeated in patients receiving blood that the Korean Red Cross Blood Center (KRCBC) had supplied. The purpose of this study is to contribute to stable and efficient blood supply in our country by analysis of present status of hospital blood banks as blood donation center and their satisfaction levels with the KRCBC. METHODS: From July to August 2004, we performed questionnaire survey in 129 hospital blood banks that the KRCBC issued donor card in 2003. Among them, 73 hospitals replied and we analyzed them. RESULTS: Fifty-one (69.8%) among 73 hospital blood banks collected less than 100 cases of blood donation in 2003 and 16 of them collected no blood component. Satisfaction level with KRCBC was only 1.8 in hospitals less than 300 beds. Improvement in the delivery of blood components and blood testing of donated blood were in highest need among all areas of services supplied by KRCBC. Hospitals more than 1,000 beds answered that they would not transfer the collection service to KRCBC no matter how NAT be performed in all donated blood because of the directed and autologous donation of their hospitals. CONCLUSION: Satisfaction level of Hospital blood banks in Korea with blood services of KRCBC was rated below average, especially in hospitals less than 300 beds. It is important that the government should be the subject of national blood services and suggest appropriate schemes such as national audit program through close cooperation with the KRCBC and hospitals.

Activities of Blood Programme in Korean Red Cross: 1990-1999 / 대한수혈학회지

BACKGROUND: The non-remunerated blood programme in Korea was delegated to the Korean Red Cross by the government since 1982 and 98% of blood for transfusion in medical facilities was supplied by KRC in 1999. This study was conducted to analyze the activities of recent ten years. METHODS: The quantities and trends of blood collection and transfusion were analyzed on the basis of annual report of Korean Red Cross. RESLUTS: Between 1990 and 1999, the number of annual blood donation increased from 1.1 million to 2.5 million units reaching 5.4 percent of total population in 1999. About 20 percent of total donation were plasmapheresis in 1999. The total number of whole blood transfusion decreased from 249,239 in 1990 to 47,814 units in 1999. The component transfusion of RBCs and Platelets increased from 0.7 million to 1.5 million and from 0.2 million to 1.1 million units, respectively. The stational donation rooms were opened actively from 1993 and more than 90 donation rooms were established in 1999. CONCLUSIONS: The total number of blood collected and transfused increased greatly. The component donation and individual voluntary donation are increasing. The quality control on blood programme conducted by Korean Red Cross was enforced.

Analysis of Satisfaction Level of Hospitals with Blood Services from the Korean Red Cross / 대한수혈학회지

BACKGROUND: Blood transfusion service has been expansively developed in quantity. As hospital users require better services, needs for qualitative improvements has increased. Currently, only limited information is available on the level of satisfaction of hospital users with services delivered by blood centers. The purpose of this study is to evaluate the levels of satisfaction of hospitals with services from the Korean Red Cross Blood Centers. METHOD: To assess quality of customer service provided by 8 blood centers of the Korean Red Cross, a questionnaire survey was performed. The questionnaire was composed of 19 items that are related to hospital users'ss satisfaction with several aspects of services including blood delivery, efficacy and safety of blood components, laboratory test, exchange of information about blood, and the supply of newly developed blood products. RESLUTS: Hospital users were largely satisfied with services provided by Red Cross Blood Centers (dissatisfaction rate: 2.3%). The level of overall satisfaction of blood collecting hospitals were relatively lower than those of the rest (p<0.01). Improvement in the delivery of blood components was in highest need among all areas of services. Most respondents recognized high need for sharing information on blood and transfusion between hospitals and blood supply centers. The demand for newly developed blood components was significantly higher in large hospitals with blood bank than those without blood bank (p<0.05). CONCLUSION: The safety of blood recipients and the efficiency of blood supply should be further improved through better blood-related services. Because of limitations in available resources, all the field of services can not be improved at the same time. For this reason, it is important to identify appropriate approaches through close cooperation between the blood centers and hospitals. To this end, a mechanism for active exchange of information should be devised.