Abstract
毛阿燕,石菊芳,邱五七,董佩,孙宗祥,黄慧瑶,孙晓杰,刘国祥,王德斌,白亚娜,廖先珍,任建松,郭兰伟,兰莉,周琦,周金意,杨莉,王家林,秦明芳,张永贞,宋冰冰,邢晓静,朱琳,买玲,杜灵彬,刘玉琴,娄培安,蔡波,孙校华,吴寿岭,齐啸,张凯,赫捷,代敏.我国城市地区癌症临床筛查服务潜在供方服务意愿调查[J].Chinese journal of Epidemiology,2018,39(2):150-156
我国城市地区癌症临床筛查服务潜在供方服务意愿调查
Willingness of potential service suppliers to provide cancer screening in urban China
Received:October 10, 2017  
DOI:10.3760/cma.j.issn.0254-6450.2018.02.004
KeyWord: 肿瘤  筛查  可持续性  服务意愿  供方
English Key Word: Neoplasms  Screening  Sustainability  Willingness-for-service  Supplier
FundProject:国家重大公共卫生服务项目(城市癌症早诊早治项目);WHO2016-2017双年度合作项目(2016/664439-0);中国医学科学院医学与健康科技创新工程项目(2017-2M-1-006);中国医学科学院中央级公益性科研院所基本科研业务费专项(2016ZX330009)
Author NameAffiliationE-mail
Mao Ayan Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China  
Shi Jufang National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China  
Qiu Wuqi Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China qiu.wuqi@imicams.ac.cn 
Dong Pei 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  
Huang Huiyao National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China  
Sun Xiaojie School of Health Care Management, Shandong University, Jinan 250012, China  
Liu Guoxiang Harbin Medical University, Harbin 150081, China  
Wang Debin Anhui Medical University, Hefei 230032, China  
Bai Yana School of Public Health, Lanzhou University, Lanzhou 730000, 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 The Affiliated Cancer Hospital of Zhengzhou University, 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  
Zhou Jinyi Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China  
Yang Li Guangxi Medical University, Nanning 530021, China  
Wang Jialin Shandong Tumor Hospital, Jinan 250117, China  
Qin Mingfang Yunnan Cancer Hospital, Kunming 650118, China  
Zhang Yongzhen Shanxi Provincial Cancer Hospital, Taiyuan 030013, China  
Song Bingbing Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China  
Xing Xiaojing Liaoning Cancer Hospital and Institute, Shenyang 110042, China  
Zhu Lin Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China  
Mai Ling The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China  
Du Lingbin Zhejiang Cancer Hospital, Hangzhou 310022, China  
Liu Yuqin Gansu Provincial Cancer Hospital, Lanzhou 730050, China  
Lou Peian Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China  
Cai Bo Nantong Tumor Hospital, Nantong 226000, 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  
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 调查未参加过国家级癌症筛查项目的医院相关工作人员癌症筛查服务意愿及原因。方法 基于16个省份的项目点,采用方便抽样方法抽取潜在供方医院(每个城市1~2家),并整群抽取与癌症筛查相关的管理及一线工作人员,开展问卷调查,采用SAS 9.4软件进行逻辑核查和数据分析。结果 共有31家医院(三级18家、二级13家)的2 201名工作人员(管理者508人、一线工作人员1 693人)参与调查;受访医院均有一定的筛查业务扩展空间,管理者中有提供癌症筛查意愿者占92.5%,68.3%认为应当由政府承担筛查筹资责任;一线工作人员希望通过项目获得的收获是提升专业技能(72.4%)和物质回报(46.8%),但又担心项目运行会干扰日常工作(42.1%)和物质激励不足(41.8%);如需加班提供筛查服务,工作人员对不同检查项目单例期望补偿额度M值为20~90元,其中三级医院是二级的2倍左右。结论 专业技能提升和物质激励是潜在筛查服务提供方服务积极性和项目可持续性的保证,在后续的项目开展中应给予重视,加班劳务补偿期望值较高,项目实施中需合理分配机构的工作负荷以更好地控制项目成本。
English Abstract:
      Objective Based on the investment for potential suppliers of cancer screening services, we assessed the reasons that affecting their participation motivation related to the long-term sustainability of cancer screening in China. Methods Hospitals that had never been involved in any national level cancer screening project were selected by using the convenient sampling method within the 16 project cities of Cancer Screening Program in Urban China (CanSPUC) with 1 or 2 hospitals for each city. All the managers from the institutional/department level and professional staff working and providing screening services in these hospitals, were interviewed by paper-based questionnaire. SAS 9.4 was used for logical verification and data analysis. Results A total of 31 hospitals (18 hospitals at the third level and, 13 hospitals at the second level) and 2 201 staff (508 hospital and clinic unit managers, 1 693 professional staff) completed the interview. All the hospitals guaranteed their potential capacity in service providing. 92.5% hospital managers showed strong willingness in providing cancer screening services, while 68.3% of them declared that the project fund-raising function was the responsibility of the government. For professional staff, their prospect gains from providing screening service would include development on professional skills (72.4%) and material rewards (46.8%). Their main worries would include extra work for CanSPUC might interfere their routine work (42.1%) plus inadequate compensation (41.8%). Medians of the prospect compensation for extra work ran between 20 to 90 Chinese Yuan per screening item respectively. For all the screening items, workers from the third-level hospitals expected their compensation to be twice as much of those working at the second level hospitals. Conclusion Professional capacity building and feasible material incentive seemed to be the two key factors that influenced the sustainability and development of the programs.
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