Abstract
石菊芳,毛阿燕,孙宗祥,雷海科,邱五七,黄慧瑶,董佩,黄佳文,朱娟,李江,刘国祥,王德斌,白亚娜,孙晓杰,廖先珍,任建松,郭兰伟,兰莉,周琦,杨莉,宋冰冰,杜灵彬,朱琳,王家林,刘玉琴,任英,买玲,秦明芳,张永贞,周金意,孙校华,吴寿岭,齐啸,娄培安,蔡波,李霓,张凯,赫捷,代敏.我国城市地区癌症筛查项目人员对筛查工作意愿倾向的多中心调查及政策建议[J].Chinese journal of Epidemiology,2018,39(2):142-149
我国城市地区癌症筛查项目人员对筛查工作意愿倾向的多中心调查及政策建议
Willingness and preferences of actual service suppliers regarding cancer screening programs: a multi-center survey in urban China
Received:August 28, 2017  
DOI：10.3760/cma.j.issn.0254-6450.2018.02.003
KeyWord: 肿瘤  筛查  服务  供方  可持续性
English Key Word: Neoplasms  Screening  Service  Supplier  Sustainability
FundProject:国家自然科学基金（81773521，81402740）；WHO2016-2017双年度合作项目（2016/664439-0）；科技部重大慢性非传染性疾病防控专项（2017YFC1308700，2017YFC1308705）；中国医学科学院医学与健康科技创新工程项目（2017-I2M-1-006）；国家科技重大专项（2017ZX10201201-008-002）；国家重大公共卫生服务项目——城市癌症早诊早治项目
Author NameAffiliationE-mail
Shi Jufang National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China  
Mao Ayan Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China  
Sun Zongxiang Harbin Center for Disease Control and Prevention, Harbin 150056, China  
Lei Haike Chongqing Cancer Institute, Chongqing 400030, China  
Qiu Wuqi Harbin Center for Disease Control and Prevention, Harbin 150056, China  
Huang Huiyao National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China  
Dong Pei Harbin Center for Disease Control and Prevention, Harbin 150056, China  
Huang Jiawen National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China  
Zhu Juan National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China  
Li Jiang National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China  
Liu Guoxiang Harbin Medical University, Harbin 150081, China  
Wang Debin School of Medical Administration, Anhui Medical University, Hefei 230032, China  
Bai Yana Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China  
Sun Xiaojie Center for Health Management and Policy of Shandong University, Jinan 250012, China  
Liao Xianzhen Hunan Provincial Cancer Hospital, Changsha 410006, China  
Ren Jiansong National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China  
Guo Lanwei Henan Cancer Hospital, Zhengzhou 450008, China  
Lan Li Harbin Center for Disease Control and Prevention, Harbin 150056, China  
Zhou Qi Chongqing Cancer Institute, Chongqing 400030, China  
Yang Li Guangxi Medical University, Nanning 530021, China  
Song Bingbing Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China  
Du Lingbin Zhejiang Cancer Hospital, Hangzhou 310022, China  
Zhu Lin Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China  
Wang Jialin Shandong Tumor Hospital, Jinan 250117, China  
Liu Yuqin Gansu Provincial Cancer Hospital, Lanzhou 730050, China  
Ren Ying Tieling Central Hospital, Tieling 112000, China  
Mai Ling Guangxi Medical University, Nanning 530021, China  
Qin Mingfang Yunnan Cancer Hospital, Kunming 650118, China  
Zhang Yongzhen Shanxi Provincial Cancer Hospital, Taiyuan 030013, China  
Zhou Jinyi Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China  
Sun Xiaohua Ningbo No.2 Hospital, Ningbo 315010, China  
Wu Shouling Kailuan General Hospital, Tangshan 063000, China  
Qi Xiao Tangshan People's Hospital, Tangshan 063001, China  
Lou Peian Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China  
Cai Bo Nantong Tumor Hospital, Nantong 226000, China  
Li Ni National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China  
Zhang Kai National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China  
He Jie National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China  
Dai Min National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China daimin2002@hotmail.com 
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Abstract:
      目的 基于癌症筛查实际供方角度，从工作人员主观感受及意愿层面评价癌症筛查项目的可持续性。方法 2014-2015年，基于城市癌症早诊早治项目，在16个省份项目点选取2013-2015年所有承担项目的医院、CDC和社区卫生服务中心，采用纸质问卷和网络调查开展访谈，对象包括宏观管理人员、具体项目管理人员和一线工作人员等。结果 最终完成访谈4 626份，访谈对象总体认为参加项目的最大收获在于社会价值感的提升（63.6%）、当地影响力（35.9%）及专业技能提升（30.6%）等；最大困难在于社会物质激励不够所致工作积极性低（30.9%）、信息采集口径不一致（28.3%）、部门间协调（24.4%）和机构间沟通衔接困难（23.5%）等。当单项筛查服务劳务补偿约50元时，工作人员会考虑加班工作。63.7%的受访者有长期筛查服务意愿，主要原因：可通过项目提升个人/团队在当地影响口碑（48.7%）、通过项目提升个人/团队专业技能（43.1%）等；无服务意愿者主要担心工作量超负荷（59.8%）、对日常工作的干扰（49.8%）等。结论 收获与困难相关结果提示，若要长期可持续性开展癌症筛查工作，建议加强项目内荣誉激励、对外宣传及专业能力建设，根据具体情况提高劳务补偿。服务意愿结果则提示，应从政府和领导层面加强信息化建设及机构/部门间协调，机构内应合理协调筛查项目与日常工作。
English Abstract:
      Objective From the perspective of actual service suppliers regarding cancer screening, this study aimed to assess the long-term sustainability of cancer screening programs in China. Methods Based on a Cancer Screening Program in Urban China (CanSPUC), our survey focused on all the hospitals, centers for disease control and prevention (CDC) and community service centers across 16 provinces in China which participated in the programs between 2013 and 2015. All the managers (institutional/department level) and professional staff involved in the program were interviewed using either paper-based questionnaire or online approach. Results A total of 4 626 participants completed the interview. It showed that the main gains from providing screening service emphasized promotion in social value (63.6%), local reputation (35.9%), and professional skills (30.6%), whereas difficulties encountered included inadequate compensation (30.9%) and discordance among information systems (28.3%). When the service remuneration amounts to about 50 Chinese Yuan per screening item, those professional staff self-reported that they would like to work overtime. More than half (63.7%) of the staff expressed willingness to provide routine screening service, the main expectations were to promote their reputation to the local residents (48.7%) and to promote professional skills (43.1%). Those who were not willing to provide screening services were worried about the potential heavy workload (59.8%) or being interfered with their routine work (49.8%). Further detailed results regarding the different organization types and program roles were presented in the following detailed report. Conclusions Findings of gains and difficulties showed that if cancer screening is expected to become a long-term running, incentive mechanism from the program, external promotion and advocacy as well as capacity building should be strengthened; furthermore, rewards to staff's screening services should be raised according to the local situations. Results regarding the "willingness to provide service" showed that management of the program should also be strengthened, including information system building and inter-agency and inter-department coordination at the government levels.
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