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

作　　者：毛阿燕[1] 石菊芳 邱五七[1] 董佩[1] 孙宗祥[3] 黄慧瑶 孙晓杰[4] 刘国祥[5] 王德斌[6] 白亚娜[7] 廖先珍[8] 任建松 郭兰伟[9] 兰莉[3] 周琦[10] 周金意[11] 杨莉[12] 王家林[13] 秦明芳 张永贞[15] 宋冰冰[16] 邢晓静[17] 朱琳[18] 买玲[9] 杜灵彬[19] 刘玉琴[20] 娄培安[21] 蔡波 孙校华[23] 吴寿岭[24] 齐啸 张凯 赫捷 代敏 无 Mao Ayan;Shi Jufang;Qiu Wuqi;Dong Pei;Sun Zongxiang;Huang Huiyao;Sun Xiaojie;Liu Guoxiang;Wang Debin;Bai Yana;Liao Xianzhen;Ren Jiansong;Guo Lanwei;Lan Li;Zhou Qi;Zhou Jinyi;Yang Li;Wang Jialin;Qin Mingfang;Zhang Yongzhen;Song Bingbing;Xing Xiaofing;Zhu Lin;Mai Ling;Du Lingbin;Liu Yuqin;Lou Peian;Cai Bo;Sun Xiaohua;Wu Shouling;Qi Xiao;Zhang Kai;He lie;Dai Min(Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China;National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Belting 100021, China;Harbin Center for Disease Control and Prevention, Harbin 150056, China;School of Health Care Management, Shandong University, Jinan 250012, China;Harbin Medical University, Harbin 150081, China;Anhui Medical University, Hefei 230032, China;School of Public Health, Lanzhou University, Lanzhou 730000, China;Hunan Provincial Cancer Hospital, Changsha 410006, China;The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, China;Chongqing Cancer Institute, Chongqing 400030, China;Jiangsu Provincial Center for Disease Control and Prevention, Nanfing 210009, China （Zhou JY;Guangxi Medical University, Nanning 530021, China;Shandong Tumor Hospital, Jinan 250117, China;Yunnan Cancer Hospital, Kunming 650118, China;Shanxi Provincial Cancer Hospital, Taiyuan 030013, China;Affiliated Cancer Hospital of Harbin Medical University, Harbin 150081, China;Liaoning Cancer Hospital and Institute, Shenyang 110042, China;Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China;Zhejiang Cancer Hospital, Hangzhou 310022, China;Gansu Provincial Cancer Hospital, Lanzhou 730050, China;Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China;Nantong Tumor Hospital, Nantong 226000, China;Ningbo No.2 Hospital, Ningbo 315010, China;Kailuan General Hospital, Tangshan 063000, China;Tangshan People＇s Hospital, Tangshan 063001, China)

机构地区：[1]中国医学科学院北京协和医学院医学信息研究所,北京100020 [2]国家癌症中心/中国医学科学院北京协和医学院肿瘤医院,北京100021 [3]哈尔滨市疾病预防控制中心,150056 [4]山东大学卫生管理与政策研究中心,济南250012 [5]哈尔滨医科大学卫生管理学院,150081 [6]安徽医科大学卫生管理学院,合肥230032 [7]兰州大学流行病与卫生统计学研究所,730000 [8]湖南省肿瘤医院,长沙410006 [9]河南省肿瘤医院,郑州450008 [10]重庆市肿瘤研究所,400030 [11]江苏省疾病预防控制中心,南京210009 [12]广西医科大学,南宁530021 [13]山东省肿瘤医院,济南250117 [14]云南省肿瘤医院,昆明650118 [15]山西省肿瘤医院,太原030013 [16]哈尔滨医科大学附属肿瘤医院,150081 [17]辽宁省肿瘤医院,沈阳110042 [18]新疆医科大学附属肿瘤医院,乌鲁木齐830011 [19]浙江省肿瘤医院,杭州310022 [20]甘肃省肿瘤医院,兰州730050 [21]徐州市疾病预防控制中心,221006 [22]南通市肿瘤医院,226000 [23]宁波市第二医院,315010 [24]开滦总医院,唐山063000 [25]唐山市人民医院,063001 [26]城市癌症早诊早治项目卫生经济学评价工作组

出　　处：《中华流行病学杂志》2018年第2期150-156,共7页Chinese Journal of Epidemiology

基　　金：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）

摘　　要：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SAS9．4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2201名工作人员（管理者508人、一线工作人员1693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肘值为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。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 fired-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.

关 键 词：肿瘤 筛查 可持续性 服务意愿 供方 

分 类 号：R197.1[医药卫生—卫生事业管理]