title: Situation analysis of prenatal diagnosis technology utilization in China: current situation, main issues, and policy implications.
abstract: OBJECTIVE
  The purpose of this study is to describe the situation with the distribution and utilization of prenatal diagnosis technology in China, to identify some important barriers to prenatal diagnosis use, and to suggest changes to improve the present situation.
  
  
  METHODS
  The study uses cross-sectional surveys to capture quantitative data from both providers and consumers. Qualitative information based on focus group discussions is also presented.
  
  
  RESULTS
  A mail survey of the provincial Bureaus of Health (BOHs) reveals that sixteen provincial prenatal diagnosis centers and twelve city level centers were accredited by the BOHs by July of 2001. These centers were located in thirteen provinces, of thirty in all of China. Of 147 selected institutions surveyed separately, 90.5 percent offer ultrasound examination, 72.1 percent provide pathogen tests (mainly Toxoplasma, rubella virus, cytomegalovirus, and herpes simplex or TORCH), 57.1 percent do biochemical tests, 21.8 percent have genetic counseling, 13.6 percent do karyotype testing, 7.5 percent do enzymology testing, and 5.4 percent carry out molecular genetic testing. Chromosome diseases, congenital diseases, and several gene diseases are the target diseases. According to qualitative data, macromanagement for prenatal diagnosis, supplier provision of tests, and population demand are the main influences on prenatal diagnosis use.
  
  
  CONCLUSIONS
  From the quantitative and qualitative analysis, it is clear that the technology of prenatal diagnosis is not diffusing well throughout China and is apparently not appropriately used. The situation of prenatal diagnosis has implications for policy-makers, including identification of priorities, regulation of prenatal diagnosis, strategic planning, development of guidelines based on health technology assessment, and consumer orientation.
authors.affiliation: Health Technology Assessment and Research Center, Fudan University, Shanghai, People's Republic of China. yychen@shmu.edu.cn
authors.forename: Yingyao
authors.initials: Y
authors.lastname: Chen
authors.forename: Xu
authors.initials: X
authors.lastname: Qian
authors.forename: Zhiliu
authors.initials: Z
authors.lastname: Tang
authors.forename: H David
authors.initials: HD
authors.lastname: Banta
authors.forename: Fangfang
authors.initials: F
authors.lastname: Hu
authors.forename: Jianwen
authors.initials: J
authors.lastname: Cao
authors.forename: Jiayan
authors.initials: J
authors.lastname: Huang
authors.forename: Qian
authors.initials: Q
authors.lastname: Wang
authors.forename: Jun
authors.initials: J
authors.lastname: Lv
authors.forename: Xianghua
authors.initials: X
authors.lastname: Ying
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
mesh_terms: D002681:China; D003430:Cross-Sectional Studies; D003625:Data Collection; D004059:Diffusion of Innovation; D005260:Female; D006291:Health Policy; D006801:Humans; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods* / Q000706:statistics & numerical data*; D013673:Technology Assessment, Biomedical