Blood Supply Chains (BSCs) are a complex set of actors, facilities and relationships, whose role is to manage the entire flow of blood units, from donors to patients, and to ensure that the total demand of blood is met (i.e. the self-sufficiency goal). To this end, the support of Voluntary Associations (VAs) is crucial, as they contribute to new donors’ recruitment and, possibly, can perform collection activities. In Italy, BSCs operate within the national health system. Data provided by the Central Government reveal that significant differences, in terms of self-sufficiency, exist across regions. In such a context, the scope of this paper is to investigate what are the organizational factors that can affect BSCs performance at the regional level. In particular, we focus our attention on two main aspects: i) the adopted organizational model, which can vary in dependence of the role played by VAs; ii) the spatial distribution of BSCs over the territory. Indeed, as blood is donated on a voluntary and non-remunerated basis, it is likely that the spatial organization of BSCs is fundamental to attract donors. With these aims in mind, we realize a field analysis, by interviewing regional managers from the main Italian association of donors. As a result, we identify the organizational models currently adopted by a sample of Italian regional BSCs. This classification is then used to perform a quantitative whose results highlight that regions adopting an Associative model, i.e. where VAs actively contribute to collection activities, tend to achieve better operational performances. Moreover, some preliminary findings from a spatial analysis seem to confirm that these performances are positively affected also by a widespread diffusion of collection facilities over the regional territory. In practice, ensuring good accessibility conditions to potential donors, through an appropriate and coordinated organization of all the actors involved in the BSC, emerge as a consolidated recommendation to decision and policy-makers.