| Objective To construct a screening index system for evaluating and screening synthetically appropriate health technology (AHT) suitable in rural areas, and to analyze the health services demand, utilization and supply of the model county, in order to provide the guidance and basis for screening economic, effective AHTs.Methods The method of Delphi was used to construct an index system of screening AHTs in rural areas. The methods of questionnaire, group interview and consulting statistics statement were used to collect the related information on health service needs, utilization and provides in the model county. All survey data was entered into computer and analysed by SPSS10.0 software.Results (l)The screening index system was constructed and the weight-value of multi-indices was given, which were primary indexes: technical characteristics (0.25), security (0.20), effectiveness(0.30), economy(0.15),social suitability(0.10) that, and secondary indexes were innovative(0.17), maturity(0.23), completeness(0.19). requirements for environment and equipment(0.22),adverse reaction rate(0.49), adverse reaction intensity(0.51), efficiency(0.49), the effect(0.51). cost-profit of medical agency(0.49), cost-effectiveness of patient(0.49), people's demand(0.28), acceptability of medical agency(0.23),doctor's acceptability (0.24),patient's acceptability(0.26).(2)In model county, two weeks prevalence was 130.4‰. and the difference of two weeks prevalence among people of different sex,age groups. educational level. occupation and economic situation was statistically significant. Within two weeks, the number of workers who rest due to illness was 40.9 per 1000. the days were 220.9. Within two weeks, the number of students absence from school due to illness was 16.7 per 1000. the days were 62.1. Within two weeks, the number of bedridden people was 25.5 per 1000, the days were 96.2. In model county, two-week consultation rate was 102.05‰, and the difference of two-week consultation rate among people of different sex,age groups,educational level, occupation and economic situation was statistically significant. 88.75% of rural residents utilized clinic service in countryside and village medical agency. Two-week non-consultation rate was 21.70%, 52.17% of rural residents didn't consult doctor due to economy difficult. In the non-consultation patients, 47.83% was self-medication and 52.17% was no treatment. In Gansu province, rural residents' hospitalization rate was 41.7‰, and non-hospitalization rate was 38.10%,and the difference of hospitalization rate among people of different sex,age groups,educational level and occupation was statistically significant. 76.65% rural residents didn't hospitalize due to economy difficult. In model county, the coverage rates of township hospital and village health-care office were 100% and 107.1% respectively. The number of beds, health workers and doctors was 1.26, 1.81 and 0.66 respectively per 1000 people. Among health workers and doctors in the county hospitals,undergraduate,college and secondary was 10.6%, 17.5% and 57.0% respectively,but in the countryside hospitals,that rates were 1.4%,9.0% and 53.2%. Fixed assets possessed by each country,countryside and village health-care agency were 1.276 million yuan, 0.581 million yuan and 0.78 ten thousand yuan respectively. 37.3% of the county CDC's income came from government's budget and 55.7% came from the income of professional services. In the last Part, 37.5% came from paid services, 26.8% was employee's health examination, and 24.1% was sanitary surveillance. In county Maternal and Child Health Agency, 27% of it's income came from government's budget and 67 % came from the income of professional services. In the last part, 3.4% came from paid services, 11.2% was clinical service, and 38.0% was hospitalization service.Conclusion A screening index system included 5 primary indexes and 15 secondary indexes, which could provide the guidance and basis for screening AHTs. In the model county, residents' health service needs was much larger but demands was more insufficient. There were significant population characteristics in rural residents' health service needs and demands,which displayed in the difference of health service demands and utilization between different sex,age group, educational level,occupation and economic situation. Prevention and cure of chronic disease were a lot of challenge for rural health workers, whose konwledge on prevention and cure of chronic disease should be strengthened. Rural health workers hungered for new heath technology, especially Chinese Traditional Medicine. Financial straits inhibited the rural residents' health service needs. In the model county, the scale of health service provides was increasing, but the efficiency was lower, and also was the quality. The government provided a part of financial assistance for public health domain, and hospitals were also. The function of rural health-care system should be strengthened.
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