我国农村妇女宫颈癌检查项目对基层医疗机构服务能力的影响分析  

Analysis of the impact of National Cervical Cancer Screening Program in Rural Areas of China on the capacities of grass-roots hospitals

作　　者：狄江丽[1] 宋波[1] 吴久玲[1] 马兰[1] 陈静宜[1] 

机构地区：[1]中国疾病预防控制中心妇幼保健中心,北京100013

出　　处：《中国健康教育》2016年第6期498-501,共4页Chinese Journal of Health Education

摘　　要：目的分析我国农村妇女宫颈癌检查项目的实施,并了解该项目对基层医疗保健机构宫颈癌检查相关服务能力的影响。方法 2014年对183个国家级宫颈癌项目县2011—2013年所具备的宫颈癌检查相关医务人员和阴道镜设备情况进行调查,对6个省12个项目县项目开展前后898张细胞学涂片进行专家复核,并对77家提供宫颈癌检查的服务的医疗保健机构的服务情况进行调查。结果 2011—2013年具备细胞学和病理阅片人员、阴道镜检查人员和阴道镜设备的项目县所占比例逐年增加,分别由2011年的61.2%、59.6%、66.1%和65.6%,增加到2013年的89.6%、87.4%、96.2%和95.1%(P<0.001);项目县具备细胞和病理阅片人员、阴道镜检查人员以及阴道镜设备的数量逐年增加,分别由2011年每县平均5.23人、3.20人、7.79人以及3.02台,增加到2013年的7.93人、4.82人、12.97人和4.92台(P<0.001)。细胞阳性涂片满意率和专家复核符合率,在项目开展前后明显提高,分别由项目开展前的92.9%和57.4%,上升到开展后的99.5%和69.1%(P<0.05)。项目开展后能提供阴道分泌物检查和宫颈细胞涂片取材的乡镇卫生院所占比例较项目开展前有明显增加(89.4%vs60.6%,83.3%vs 45.5%;P<0.001)。结论我国宫颈癌检查项目的实施,不仅加强了项目地区基层医疗保健机构的人力和设备资源,同时也促使医务人员的服务能力和宫颈癌检查服务的可及性得到了不同程度的提高。Objective To analyse the impact of National Cervical Cancer Screening Program in Rural Areas （NCCSPRA） of China on the capacities of hospitals which provided cervical cancer screening services in project areas. Methods A survey about the situations of project counties was conducted in 183 project counties. A total 898 of smear slides before and after program complementation were reviewed by national experts. A field survey about situations of the hospitals which provided the cervical cancer screening services was conducted in 12 project counties in 6 provinces. A total of 77 hospi- tals responded the questionnaire of hospital. Results From 2011 -2013, the proportions of project counties which had cy- topathologists, pathologists, colposcopists and colposcopies were increased with years. The proportions were increased from 61.2%, 59. 6%, 66. 1% and 65.6% in 2011 to 89. 6%, 87.4%, 96. 2% and 95.1% in 2013, respectively （P〈 0. 001 ）. The numbers of cytopathologists, pathologists, colposcopists and colposcopies in project counties were increased with years. The mean number of different doctors and colposcopies were increased from 5.23, 3.20, 7.79 and 3.02 in 2011 to 7. 93, 4. 82, 12. 97 and 4.92 in 2013, respectively （P 〈0. 001 ）. There was a statistically significant difference of the adequate cytology rates and interpretation agreement rates between before and after program complementation （ P 〈 0. 05 ）. The adequate cytology rates and interpretation agreement rates were increased from 92. 9% and 57.4% to 99. 5% and 69. 1%, respectively. The proportions of township hospitals which could provide vaginal discharge examination and Pap smear sample taking after program were higher than before program （89.4% vs 60. 6%, 83.3% vs 45.5%, P 〈0. 001 ）. Conclusion The implementation of NCCSPRA not only strengthened the human and equipment resource of grass-roots hos- pitals, but also facilitated the improvement of the capacities of health workers and the accessibility and availability of cervical c

关 键 词：宫颈癌 检查项目 基层医疗机构 服务能力 

分 类 号：R193[医药卫生—卫生事业管理] R737.33[医药卫生—公共卫生与预防医学]