Economics Evaluation On Appropriate Health Technology Spreading And Application In Countryside

Objectives Health economics principle was applied to study the training of countryside Appropriate Health Technology (AHT) and the generalized cost-effectiveness, the cost - benefit. From the viewpoint of ecnomics , both the effect of different trainings of AHT and different spreadings were appraised systematically and objectively. Then we tried to provide the scientific basis to optimize the effective pattern of training and application of AHT, and to formulate the unified achievements appraisal system and the standard assessment method.Methods Based on the data from the project financial report, the training effect investigation table, the spreading application registration form and feedback investigation table and etc., we collected the related information about the investment of countryside AHT from varies institutions, the diagnoses and the treatments of patient, the technical service personnel and the project management in the period from Dec, 2004 to Dec. 2006 in Gansu Province. With the information the cost- effectiveness of training was appraised in terms of the index of recognized rate, average record and satisfaction. And the cost-effectiveness of spreading was appraised in terms of the index of efficiency. Furthermore, based the 520 case histories of intracranial hematoma taken from two county hospitals in the period between July, 2004 and June 2006, using the method of the comparison of pre-and post-treatment and the comparison of different treatments, the cost- effectiveness and cost-benefit was appraised with the help of the therapeutical index of the rate of usage, fatality and cure and economical index of inpatients' costs.Results (1) It costed more 66.96 RMB per person trained in the mode of centralized in the provincial institution than in the countryside institution for unit mark. (2) According to survey of the different technologies' cost, for the proportion of direct cost in total cost of spreading per person, the technology of Chinese Traditional Medicine was 75.51%, the technology of the family plan is 70.00%, and the technology of modern medicine was 68.10%. And with the survey of different spreading modes, for the proportion of direct cost in total cost of spreading per person, the mode of "objective demand-government support- preferment policy" was the highest up to 73.2%. Therefore, the manager of projects, the technical user, and the technical receiver thought that the spreading AHT could reduce the local patient's burden. (3) According to invesigation of effectiveness of the intracranial hematoma shatter pin technology micro-wound purge, in the two sample counties the patients using the intracranial hematoma shatter pin technology micro-wound purge increased 71 samples and the percentage of users increased 10.12% after spreading AHT. And the average stay days in hospitals decreased 2 days. (4) According to the analysis of three different treatment methods, the fatality rate of the intracranial hematoma shatter pin technology micro-wound purge was 7.14%, comparing to 20% of craniotomy surgery and 10.69% of conservative treatment of internal medicine. The inpatients' costs per person in a day decrease 161.35 RMB comparing to craniotomy surgery. And the costs of medicine, diagnosing and accompanying person were all decreased. 5) With the cost - effectiveness analysis of spreading the intracranial hematoma shatter pin technology micro-wound purge, the ratio of the total (direct) spreading cost per person to the rate of usage was 3.90(1.71):l. And the ratio of the total spreading cost per person and the rate of cure was 6.50:1, in which the direct spreading cost per person and the rate of cure was 2.93:1 . Both 19.71 RMB of total spreading cost and 8.90 RMB of direct spreading cost were needed for decreasing an average stay day in Hospitals. (6) According to survey of the intracranial hematoma shatter pin technology micro-wound purge, the inpatients' costs of the intracranial hematoma shatter pin technology micro-wound purge per person could reduce 706.79 RMB comparing to craniotomy surgery, which made pure benefit was 667.37 RMB and the ratio of the spreading cost to saving of inpatients' costs was 1: 16.93, i.e. The direct benefit for a family obtained 1 RMB for spreading AHT was 16.93 RMB.So that it was a project which had much higher benefit with low investment.Coclusions The multi-department's cooperation network was formed for the spreading of countryside AHT in the first time. In our research the benefit supplementary of Supply-demand Coordination was considered from different angles, and appraising index system of training effectiveness - pattern - economy was formed. With investigating training investment-output with multiple perspectives and the multi-level, we discussed the effect and benefit of three kinds of different spreading patterns. The scientific basis of spreading AHT is provided for optimizing spreading pattern, constructing appraisal system of project management, and forming spreading mechanism coincident with the policy, the economy, and the region characteristic of northwest regional.