中国适宜卫生技术推广应用的系统评价  

Promotion and Application of Appropriate Health Technology in China: A Systematic Review

作　　者：罗燕[1] 刘琴[1] 郭雪[1] 王润华[1] 

机构地区：[1]重庆医科大学公共卫生与管理学院,重庆400016

出　　处：《中国循证医学杂志》2014年第6期683-690,共8页Chinese Journal of Evidence-based Medicine

基　　金：重庆市卫生局2011年医学科研重点项目(编号:2011-1-138)

摘　　要：目的系统评价国内适宜卫生技术推广应用的模式与机制、效果及其影响因素。方法计算机检索VIP、CNKI、CBM和WangFang Data数据库,纳入有关适宜卫生技术推广应用的研究,检索时限均为从建库至2013年1月。由两名研究者按照纳入与排除标准独立筛选文献、提取资料和交叉核对,并对纳入的随机对照试验进行质量评价后,采用定性方法系统归纳总结。结果最终共纳入73个研究。研究对象主要包括提供或开展适宜卫生技术的基层医务人员或推广组织人员、医疗机构及其相关负责人和接受适宜卫生技术治疗或服务的患者。主要涉及中医、西医、计划生育、妇幼卫生及社区卫生服务5个方面的适宜卫生技术的推广。研究结果显示,除政府主导型模式应用较广泛外,还有政府引导型、政府推动型、市场主导型及第三部门主导型4种模式。项目经费、组织管理、技术持有者、技术服务供需双方及技术等因素都会影响适宜卫生技术的推广应用。在推广应用的评价研究中,需求评价研究较少,单个过程评价研究内容较为局限,效果评价主要为横断面研究。结论本系统评价结果显示,可持续发展的适宜卫生技术推广模式需在充分考虑市场和人群客观需求的基础上,采用政府主导或引入第三部门主导模式,同时针对影响适宜卫生技术推广应用的不同因素采取相应措施。在今后的评估研究中,仍需开展设计严谨的高质量研究,并采用综合的评价方法,全面评价适宜卫生技术的推广应用效果。Objective To systematically review the model and mechanism, efficacy and its influencing factors of the promotion and application of appropriate health technology in China. Methods Such database as VIP, CNKI, CBM and WanFang Data were electronically searched to collect studies on the promotion and application of appropriate health technology in China published from the establishment dates to January 2013. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted and cross-checked data, and assessed quality. Qualitative synthesis method was used to systematically summarize the included studies. Results A total of 73 studies were finally included. Targeted populations included primary medical staff and personnel who provided or developed appropriate health technologies, medical institutions and their managers, as well as patients who received service or treatment of appropriate health technology. The promotion of appropriate health technologies mainly contained five fields： Chinese medicine, biomedicine, family planning services, maternal and child health, and community health services. The government-leading model had been widely applied currently, besides, there were other four models： government-guidance, government-driven, market-leading and a third sector-leading models. Factors related to project funding, organization and management, technology holders, the supply and demand parties in technical services and technology itself might affect the application of appropriate health technology. Among all evaluation studies, the number of needs assessment was less, the contents of process evaluation were one-sided and the effect evaluation was mainly cross-sectional studies. Conclusion This study shows that sustainable development of appropriate health technology promotion model need to fiflly consider market demand and people＇s needs, on the basis of using government-leading or introducing a third sector-leading model. Corresponding measures should be taken a

关 键 词：适宜卫生技术 推广应用 系统评价 

分 类 号：R197.1[医药卫生—卫生事业管理]