The Study Of Assessment Of Appropriate Health Technologies For Use In Rural Areas Of Zhejiang Province

ObjectivesTo establish an assessment model of appropriate health technologies for use in rural areas of Zhejiang province, and apply it in three health technologies. It was hoped to provide a scientific and normative management mode for dissemination of rural appropriate health technologies in Zhejiang province.Methods1 Methods of indicator system: A series of indicators were selected with the Delphi method to obtain the assessment indicators. Indicators were determined by analytic hierarchy process and percent weighting method.2 Methods of evaluation: (1) Sampling method: Cluster sampling, stratified sampling, cluster stratified sampling. (2) Evaluation: The health technologies were evaluated by the assessment model for selection and assessment of rural appropriate health technology in Zhejiang province. Each indicator was scored. (3) Scoring criteria: According to the questionnaire, interview, Evidence-Based Medicine, expertise, practical situation of use, and so on.3 Statistical analysis: Microsoft Excel 2003 and EpiData3.1 were used for data entry. T-test, chi-square test, rank sum test were used for data analysis with software SPSS 13.0 for Windows.Results1 Delphi method: The degree of positivity and authority of consultants were high. The coordination coefficients for the consultants' opinions were 0.203 and 0.334 in two rounds respectively. Totally there were 66 indicators in the final assessment model, including 7 first-level indicators, 23 second-level indicators, and 36 third-level indicators. The compound weights for each indicator were determined. The first-level indicators were maturity (weight 0.1286), need (0.1573), convenience (0.0890), safety (0.2344), validity (0.2295), economic attributes (0.1028), sociality and ethicality (0.0584).2 Application of assessment model: (1) Nerve block for the treatment of chronic pain: The weighted score of first-level indicators were 9.84, 12.24, 5.13, 21.01, 12.97, 8.64 and 5.61 respectively. The total score was 75.44. Maturity: good; need: good; convenience: fair; safety: very good; validity: fair; economic attributes: very good; sociality and ethicality: very good. (2) Diagnosis of infantile vitamin D deficiency rickets by bone alkaline Phosphatase detection: The weighted score of first-level indicators were 8.05, 8.06, 6.32, 18.13, 18.88, 4.84 and 4.36 respectively. The total score was 68.64. Maturity: good; need: fair; convenience: good; safety: good; validity: very good; economic attributes: fair; sociality and ethicality: good. (3) DP-2.0 type portable electrocardiogram: The weighted score of first-level indicators were 2.41, 9.97, 6.18, 18.87, 16.06, 6.87 and 5.32 respectively. The total score was 65.68. Maturity: very poor; need: good; convenience: good; safety: very good; validity: good; economic attributes: good; sociality and ethicality: very good.Conclusions1 . With consideration of the social economic status of Zhejiang rural areas, the assessment model was valid and feasible, which could be used to select and assess rural appropriate health technologies before and after large-scale utilization inZhejiang province and other economic developed areas.2 Conclusions of evaluation: (1) Nerve block for the treatment of chronic pain: It is suitable for dissemination and application in county-level health organizations in Zhejiang rural areas. (2) Diagnosis of infantile vitamin D deficiency rickets by bone alkaline Phosphatase detection: It is suitable for dissemination and application in township-level health organizations in Zhejiang rural areas. (3) DP-2.0 type portable electrocardiogram: It can be applied in village-level health organizations in Zhejiang rural areas. However, because of data missing, it is suggested to re-evaluate this technology further.