台灣社會的人口老化問題日益嚴重，生育率下降及少子化情況使得年輕捐血族群比率下降，而老齡化社會與老年人口增加則加速用血量增加的趨勢，未來可能因人口結構之消長，產生血液供需的嚴重缺口。本研究以人口結構的趨勢變化為基礎，結合健保資料庫中的用血資訊，推估未來血液的供給與需求，本研究同時考量人口結構外之質化因子如醫療科技與政策的改變以及文化變遷等，透過Cooke 古典模型整合專家意見，並在搭配實證數據後，以蒙地卡羅模擬方法求得更合理的預測。研究指出加入非人口結構因素後，血液供需之缺口將可下修約四分之一，但 2033 年的缺口仍有百分之九十的機率落在170,712與463,299單位間。在血液管理方案的效益評估方面，本研究指出寬放捐血年齡無法明顯消弭供應缺口，但提供額外捐血誘因或者改變醫療給付政策則有較大效益，研究結果可提供相關單位決策之參考。

Population aging is currently shifting the distribution of Taiwan’s population towards older ages. The changes in demographic structure seriously affect the blood supply because eligible blood donor population consists primarily of young and healthy individuals while the patients requiring blood transfusions belong to the older age groups. Thus, this population-based study aims to estimate the future supply and demand of blood based on changes in demographic structure and the data of blood donation and transfusion in the national health insurance database. In particular, for taking factors other than demographics into consideration, this research also elicited expert judgments on the effects of the advances in medical technologies, policy changes, and cultural changes on the supply and demand of the blood product. Cooke’s classic model was used to aggregate the probability distribution judgments provided by different experts and the Monte Carlo simulation method was implemented to obtain a predicted distribution of the gap in blood supply (in year 2033). The research pointed out that after adding non-demographic factors, the average gap in blood supply and demand in 2033 will be reduced by about one quarter. The simulated results also showed that that there will be 90% probability that the gap will fall between 170,712 and 463,299 units. In terms of the effectiveness of mitigation strategies, this research showed that a more lenient age restriction could not significantly eliminate the gap while providing additional incentives to blood donors or changing the medical treatment polices should be more effective.

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