Research On The Factors Affecting The Adoption Of High Value Medical Consumes In Less Developed Areas

Objective: Taking the stapler as an example, to investigate the situation of high value medical consumes in our country, and explore the factors affecting the adoption of high value medical consumes in less developed areas. The purpose was to provide a favorable theoretical basis and practical instructions for further research and policy-making.Methods: Qualitative survey and quantitative survey were performed. 714 medical records were selected from prefecture-level and county-level hospitals in Hubei, Henan, Sichuan and Shandong provinces to collect data and 117 relevant personnels were chosen for individual interviews. Qualitative data was analyzed by Clolaizzi and quantitative data was done by descriptive analysis, rank sum test, chi-square test and logistic regression.Results:1. Baseline of staplers'adoption(1) The rate of staplers'adoption was 76.09% in prefecture-level hospitals, and 52.20% in county-level hospitals. And the difference between them was significant (χ~2=43.88, P <0.01).(2) The rates of staplers'adoption were 62.83%, 58.82%, 72.48% and 83.33% in Hubei, Henan, Sichuan and Shandong respectively. And the difference among them was significant (χ~2=18.91, P <0.01).(3) The rates of staplers'adoption were 85.53%, 71.84%, 60.87% and 52.58% in esophagectomy, gastrectomy, colectomy and rectectomy respectively. And the difference among them was significant (χ~2=36.27, P <0.01). (4) The rates of staplers'adoption were 54.84%, 65.32%, 62.80%, 68.35% and 76.19% in patients whose ages were less than 40y, 40y~, 50y~, 60y~ and 70y~ respectively. And the difference among them was not significant.(5) The rate of staplers'adoption was 65.13% in male, but 67.97% in female. And the difference between them was not significant.(6) The rates of staplers'adoption were 72.09%, 59.20% and 69.11% in patients with urban basic medical insurance, NRCMS and other types of insurances respectively. And the difference among them was not significant.2. Drivers and barriers of staplers'adoption(1) Drivers of staplers'adoption were very strong positive views about stapler among surgeons and hospital leaders, domestic vendors'channel support as well as rapid market growth.(2) Barriers of staplers'adoption were lack of NRCMS reimbursement for stapler in most locations, surgeons'skills on procedure and staplers and patients'affordability, and barriers mainly existed in county.Conclusions: In order to enhance reasonable adoption of medical consumes in less developed areas, application scope of high value medical consumes should be enlarged in NRCMS, doctors'operating skills should be improved as well as the basic medical security system should be perfected.