我国城市地区癌症临床筛查服务潜在供方服务意愿调查

摘要

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 (1 8 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.%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.