四川省农村地区基层医疗卫生服务机构开展乳腺癌筛查的能力评估  

Evaluation on the abilities to screen breast cancer at primary medical institutions in rural areas of Sichuan province

作　　者：李卉[1] 赵莹[2] 齐亚娜[2] 应桂英[3] 甘华平[3] 力晓蓉[3] 李佳圆[2] 

机构地区：[1]四川省第二人民医院(四川省肿瘤医院/肿瘤研究所)乳腺科,四川成都610041 [2]四川大学华西公共卫生学院(华西第四医院),四川成都610041 [3]四川省卫生信息中心,四川成都610041

出　　处：《现代预防医学》2014年第4期647-650,657,共5页Modern Preventive Medicine

基　　金：四川省卫生厅科学研究基金(080321、100361);成都市科技局科技支撑项目(11PPYB002SF-289)

摘　　要：目的综合评价四川省农村基层医疗卫生服务机构开展乳腺癌筛查的能力。方法通过查阅文献、德尔菲法和专题小组讨论制定了机构建设、人力资源、筛查设备配置和公共卫生服务四大类指标体系;运用既往资料收集、现场观察、电话访问,获取四川省40家乡镇卫生院的各类指标,统计描述机构的乳腺癌筛查能力,采用t检验或χ2/Fisher检验方法比较不同经济水平地区和不同地理地貌地区机构的各项评价指标差异。结果本次调查的乡镇卫生院的平均业务用房面积(1 484±1 345)m2、设置床位(19±13)张,平均每家机构的在岗工作人员(23±21)人,其中卫生技术人员(19±16)人,占82.61%,在岗员工中大专及以上学历所占比例为34.78%,经济水平较高地区资源相对丰富。40家调查机构中只有2家(5.00%)配备有乳腺高频超声,没有机构配备有钼靶X线,仅有2家机构(5.00%)参与过乳腺癌筛查项目。结论四川省农村基层医疗卫生服务机构的基本建设和人力资源低于全国平均水平,应加强农村基层卫生机构的硬件投入和人力资源配置,为今后执行国家在农村地区开展乳腺癌等肿瘤筛查的计划提供保障,实现新医改服务均等化的目标。Objective The study was conducted to evaluate the abilities to screen breast cancer at primary medical institutions in rural areas of Sichuan province. Methods Literature review, Delphi method, and focused group discussion were implemented to select evaluation indexes, including institution construction, human resources, configuration of screening equipments and public health services. Previous document reviewing, field observation, and telephone interview were employed to collect information on 40 township health centers in Sichuan province. The abilities to screen breast cancer in the investigated institutions were statistically described and compared by t test or x2/Fisher＇s exact test in different regions stratified by their GDPs and geomorphic features. Results The average business occupancy area of township health centers was 1,484 ＋ 1, 345 m2 with 19 ~ 13 beds. There were 23 ＋ 21 personnel per each center, including 19 ~ 16 health technical person （82.61%） on average. The proportion of college degree and above among all personnel was 34.78%. The health resources in the areas with higher economic level were richer. Among all 40 township health centers, only two institutions （5.00%） were equipped with breast ultrasound, no institution was equipped with mammography, and two institutions （5.00%） took part in breast cancer screening. Conclusion The institution construction and human resources of primary medical institutions in rural areas of Sichuan province were below the national average level. Elevating and allocating hardware and human resources appropriately in rural health service should be strengthened to provide support for breast cancer or other screening plans, so that the new medical reform＇s goal of health care equity can be realized in the future.

关 键 词：农村 基层医疗卫生服务机构 乳腺癌 筛查 

分 类 号：R192[医药卫生—卫生事业管理]