Research On The Synthetical Evaluation Of The Appropriate Health Technologies Transferring In Rural Areas

Research PurposesThis research is to use qualitative and quantitative methods to develop an comprehensive and scientific evaluation indicator system with high validity, reliability and differentiation for evaluating transferring and application of Appropriate Health Care Technologies in Rural of developed areas of China, which is suitable for the current development situation of transferring of Rural Appropriate Health Care Technology and easy to carry out and spread, taking Zhejiang province as research base in empirical evaluation, and thereby to improve the scientific, standardized and normalized administration level of transferring and using appropriate technology for health, also provide reference and basis for discussing of promotion application mechanism transferring of Rural Appropriate Health Care Technology.Research MethodsThis study establish research framework and structure by analyzing and referring the basic theory and method of health technology assessment, health evaluation and comprehensive evaluation, and related research achievements at home and abroad; in this study, literature review and analysis, personal interview, group discussion, field investigation and delphi method were used to develop the indicator system, Analytic Hierarchy Process(AHP) and Percent weighting method was used to calculate the weight of the indicators; Factor analysis, Cronbach's alpha coefficient,Cluster analysis and ANOVA analysis were adopted to test the validity, reliability and differentiation of indicator system; Comprehensive indicator method, Topsis method, Accumulative synthtical grading evaluation, Rank Sum Ratio(RSR) method were applied to evaluate transferring of the rural appropriate health technology in 5 demonstration counties of Zhejiang province.Research Results1. An evaluation indicator system for transferring of the rural appropriate health technology is to be developed in three aspects of the structure, the process and the outcome indicator, by means of experts consultation, key informant interviews, etc. Meanwhile, each category of indicator is to be classified into 3 classes according to its levels.2. The evaluation index system was established including 49 indexes:3 class 1 indicators,11 class 2 indicators and 35 class 3 indicators.3. The weighting of each class of indicators is determined by experts consultation, Analytic Hierarchy Process(AHP) and Percent weighting method. The weighting of class 1 indicators is 0.2680,0.3134 and 0.4186 respectively. The weighting of class 2 indicators is 0.1397,0.1283,0.0819,0.0788,0.0783,0.0744,0.0851,0.900,0.0787,0.0851 and 0.0797 respectively.4.Factor analysis to each classes of evaluation indicators is made to test the structure validity of the indicator system, The factor analysis of the second class indicators showed that totally three common factors were extracted,the accumulative variance reached 96.080%.The common factor 1(F1) is mainly influenced by variable "appropriate health technology select" and "health technology teaching", etc., it could be named as process indicator, F2 influenced by variable "The government support" and "organization and management", etc., it could be named as structure indicator; F3 is mainly influenced by variable "degree of satisfaction" and "diseases diagnosis and treatment", etc., and it could be named as outcome indicator. The results of factor analysis are accordant with the expected results and it shows the indicator system has good validity.5.The internal reliability of indicators is reflected by calculation of Cronbach's coefficient a. The standard value of Cronbach's coefficient a for class 2 indicators is 0.830; the standard value of Cronbach's coefficient a for class 3 indicators is 0.928.The value of a for class 2 and class 3 indicators are all larger than 0.7, indicating higher reliability of indicators.6. According to the cluster analysis, it is appropriate to divide the 5 demonstration counties into 3 groups, and the ANOVA analysis showed that the differences among the three groups are statistical significant (P<0.05), the differentiation of the indicators is good.7. The results of comprehensive evaluation showing relevant convergence of different evaluation methods, indicate that these evaluation indicators can be used for the evaluation of the appropriate health technologies transferring in rural and the evaluation indicator system is relatively stable.Conclusionsl.The results are relatively reliable as evaluation indices are screened with Delphi expert consultation and group discussion method, etc., the evaluation system has relatively reasonable structure as well as integral and complete contents in evaluation.2. On the basis of judgment by experts, the weighting of indicators is calculated with Analytic Hierarchy Process(AHP) and Percent weighting method to ensure scientific, accurate and reasonable calculation results.3. The evaluation system has good validity, reliability and differentiation, it is suitable for evaluating the appropriate health technologies transferring in rural.4. The results of different comprehensive evaluation methods shows the evaluation indicator system has good stability and operability, and also indicates that the evaluation indicator system developed can be used for evaluation, of the appropriate health technologies transferring in rural.5. The results of comprehensive evaluation show that the achievement of the appropriate health technologies transferring in rural is effected by the extension model of it.6. According to the characteristics of appropriate health technology, give full play to the government's role, form long-term effect mechanism for promotion the appropriate health technologies transferring in rural.