The Assessment Study On Administrative Technology For Sporadic Infectious Cases

Ⅰ.Objectives:The purpose of this study was to assess the suitability of the administrative technology for sporadic infectious cases (ATSC) in the assessment model of appropriate health technologies for use in rural areas of Zhejiang province, and explore the suitable conditions and dissemination value of this technology in the local context.Ⅱ.Methods:1、Literature ResearchReviewed the literatures related to the development of Chinese epidemic management system. Reviewed the literatures related to HTA theories and methods in the world to prepare for the succedent single technology assessment.2、Qualitative Research(1)Select subjects:1group of experts,2groups of grass-roots doctors, and2groups of patients, each group of6people.(2)Method:Focus group discussion.(3)Data analysis:Framework approach.3. Personal investigation(1) Select subjects:25doctors at grass-roots using ATSC and135patients who had received the service of ATSC in the time interval.(2) Data analysis:Epidata3.1was used for data entry, Descriptive statistics were used for data analysis by SPSS16.0.4. Organizational investigation(1) Select subjects:All the19hospitals of township level in Shaoxing county.(2) Method:Item cost accounting and time coefficient allocation.5、Synthetical evaluationThe assessment model of appropriate health technologies for use in rural areas of Zhejiang province served as an evaluation tool, data was collected in qualitative and quantitative ways.Ⅲ.Results:1、Qualitative Research(1) Experts discussion:Overall, the epidemic in Shaoxing county during the recent years was decreasing, and the disease management affairs were closely contacted with floating population. ATSC is suitable for the diseases which were common and could be easily handled by the township level. In the long ran, ATSC was supposed to cut down the frequency of Public health events and enhance the ability of local doctors.(2) Patients:All the diseases that patients enrolled in the discussion infected were very common in the local area, the disease burden was fairly easy. All the patients had received normative service from doctors. As a feedback, they wanted the service in the future more painstaking and detailed.(3) Doctors:In the grass-roots, the disease management affairs were closely contacted with floating population. The epidemic of Class C infectious diseases and sexually transmitted diseases were noticeable. ATSC was more normative than the work before, but false information from the patient was rather troublesome. Epidemic monitoring was considered the most important process. As a feedback, they suggested more fund from the government so as to make the service more detailed and more attractive to patients.2、Organizational investigationAround the year2010, the cost of the ATSC service was42.1RMB per patient, or0.02RMB per resident.3、Synthetical evaluation The weighted score of first-level indicators were0.92,10.59,5.62,23.44,13.99,7.55and4.56respectively. The total score was66.67. Maturity:very bad; need:good; convenience:good; safety:very good; validity:good; economic attributes:good; sociality and ethicality:good.Ⅳ.Conclusion:Based on the information gathered from the qualitative and quantitative study, the total score was66.67. ATSC is suitable for dissemination and application in county-level and town-level health organizations in Zhejiang rural areas. However, because of the limitations on research design, it is suggested to re-evaluate this technology futher.