Study On Both Extension Model And Factors Influencing In Extension And Application Of Appropriate Technology Of Medicine In The Countryside

Objects:Through evaluation of the using effect of rural appropriate health technology, to analyze the factors on affecting the use of rural appropriate health technology.To explore the effective promotion of appropriate technology model and to provide scientific data for the promotion of rural health appropriate technology in future.Methods:1)Baseline survey:From September 2004 to January 2005,questionnaire survey Was charged for out-patients,in-patients and discharged patients on the various medical institutions in Lintao county and Jingning county of Gansu province (discharged patients with complete medical record detailed to fill in),in order to understand out-patient and in-patient status of the local medical institutions.2) Application survey:From February 2005 to August 2006,technologies were trained and promoted and the promoting was gotten through the "appropriate technology application registration table" completed by trainees.3)Feedback evaluation survey of different groups on appropriate technology:final questionnaire survey was conducted in project counties from September 2006 to December 2006,the questionnaire was designed by Beijing traditional Chinese university and the technical evaluation questionnaire was designed by team of Gansu province.The survey was carried to the managers of counties and towns,trainees and patients using appropriate technology in order to evaluate the application effect and factors influencing promotion.4)Qualitative interviews:the interviews were conducted in the authorities of health Organization,trainees and patients using appropriate technology,four groups respectively,8—10 people each,in order to get the relevant information about promoting effect and influencing factors of appropriate technology.Results:(1)Overall application:promoting coverage of rural appropriate health technology in the medical institutions of counties and towns reach 100%;utilization of appropriate technology in counties and towns is 100%and 61.90%;utilization of technology was significant(p＜0.01);in the promoting periods,657 cases were used medical technology,1609 cases with TCM technology,23828 cases with family planning technology.(2)Application Evaluation:①Comparison of using before and after about some technology:After the promotion of minimally invasive intracranial hecatomb removal,it was significant by comparison between treatment costs of intracranial hecatomb hospitalization and that before promotion,The costs saved 1040 Yuan than the original method.The efficiency was statistically significant by comparison between the promoting treatment and the original method(p＜0.05)and was improved by 18.46%;After the promotion of standardization treatment of chronic heart failure,hospitalization costs was statistically significant compared to pre-promotion and saved 350 Yuan than before;The efficiency of treating chronic heart failure was statistically significant compared to the original method(p＜0.05) and was improved by 11.93%.②Feedback evaluation of different groups:(一) managers:Managers accounted for 77.78%and 68.29%respectively think the promotion of appropriate technology was efficient to prevention and treatment of diseases and the overall effect of lowering the overall level of disease costs.(二) Medical staff:trainees accounted for 62.50%think the technology was better than then the original technology;trainees accounted for 75.00%,87.50%and 82.5% respectively think the technology application didn't reduce the number of same group,incomes of sections and personal incomes;the subjective effect of trainees on TCM and Family planning medical technology have good statistical,significance (p＜0.01).(三)Follow-up patients:83.26%of patients think appropriate technology is better than that of original technology,78.28%consider it a low-cost technology, 76.02%consider it a short case.(3)The factors of the promotion of appropriate technology:71.11%of project managers think it lack of funds,44.44%believe that conditions are not supporting software and hardware,35.56%think it wasn't accepted by farmers;54.53%of Chinese medicine trainees believe it have no a supporting equipments and instruments,50.00%of medical trainees think no matching drugs.(4) Promotional model exploration:The prerequisite for promotion--the crowd objective needs and the objective attributes determine the promotional model which is suitable for the promotion of local model,market-led—the guide—the proliferation of autonomous mode was adopted by Western technology;TCM technology used mode of object demand--government support --dumping policy;family planning use the model of objective demand--government led --government conduction.Conclusion:(1)The promotion of rural health appropriate technology in the counties had gotten good results.The advantages of some technology have played out,the promotion had no effect on incomes of hospitals,and individuals and the number of patients,but also follow-up patients consider it an effective,low-cost,small painful and more convenient technology.(2)The main courses depend on inadequate funds, no matching hardware and software conditions.(3)The three models are suitable for the matching promotion,but the chose of promotion model should depend on technical characteristics,economic conditions in various regions and differences between counties and townships.