Research On Cancer Screening Service Capacity Of Primary Health Facilities Based On ROCCIPI

Objective: The study was based on a questionnaire survey to understand the status of breast cancer,cervical cancer and colorectal cancer screening in community health facilities,to identify the problems and influence factors of screening capacity.ROCCIPI technology was adopted to an comprehensive analysis in Rule,Opportunity,Capacity,Communication,Interest,Process and Ideology,to explore the feasibility of carrying out cancer screening in community health facilities.Seeking the optimal strategies to improve the reasonability of cancer screening projects.Methods: A total of 262 community health facilities and 554 medical staff on breast cancer,cervical cancer and colorectal cancer screening were investigated.The study designed two questionnaires,for community health facilities and medical staff respectively,including general situation of cancer screening,the effect of screening,work of staff training and dissemination,the demographical characteristics of staff,screening service capacity,willingness to work,the factors affecting of screening,and so on.Data envelopment analysis(DEA)was used to evaluate the efficiency of cancer screening in different institutions.Logistic regression model was used to analyze the Influencing factors of work willingness.Finally,ROCCIPI technology was adopted for qualitative analysis to evaluate screening service capacity of community health facilities.Results: 1.36.1% breast cancer screening institutions had ultrasonography,none of them had mammography.52.2% cervical cancer screening institutions could complete Pap smear test.As for colorectal cancer screening institutions,100.0% of them could complete fecal occult blood test,and 5 institutions have colonoscopy.The manpower input for gynecological cancer screening was insufficient,more than half of them just had no more than 5 staff on that.64.9% colorectal cancer screening institutions had more than 10 staff.Only about 60% institutions completed the annual screening tasks of breast cancer and cervical cancer,and 93.3% institutions completed the annual screening tasks of colorectal cancer.The results of DEA showed that there are 57.9%,62.6%,and 49.0% institutions had low work efficiency in breast cancer,cervical cancer,and colorectal cancer screening,respectively.Pure technical efficiency(PTE)of most colorectal cancer screening was 1,and PTE of gynecological cancer screening institutions were lower,suggesting that they'd better improve the management levels.The results of DEA for all kinds of cancer screenings showed that the high-efficiency institutions in breast cancer,cervical cancer and colorectal cancer accounted for 33.8%,24.8%,and 42.8% in the total number of each cancer screening institutions,respectively,and the difference was significant statistically.2.Nearly half of the medical staff engaged in breast,cervical and colorectal cancer screening were junior or no title.The proportion of low-level title workers was higher than the standard.The major of gynecological cancer screening staff were mainly comprised by clinical medicine,account for 70.3%,70.8%.67.2%,72.1%,and 74.3% the staff were willing to undertake breast,cervical and colorectal cancer screening.Moreover,the willingness was related to the manpower allocation of institutions.The more reasonable manpower distribution,the stronger willingness to work.Conclusions: The study combined quantitative analysis results with literature research for ROCCIPI analysis,and the following conclusions were drawn: 1.There are sufficient opportunities for community health facilities to carry out cancer screening,but China has not yet formed a standardized system.Moreover,lacking of the ability of manpower,technology,facilities in institutional,low titles in staff,unreasonable major allocation and weak willingness to work lead to bad results and effects.2.The current ability of community health facilities are insufficient to support breast and cervical cancer screening.It should strengthen the allocation of manpower and technologies,to improve the effects of breast and cervical cancer screening.3.The effect in colorectal cancer screening is better,but the medical staff have lowlevel titles and poor knowledge of screening.In addition,community health facilities focus more on clinic than prevention.4.It is necessary to enhance the recognition and cooperation of residents.Also,the effect of screening can be improved by strengthening the screening awareness,improving salary and quality of staff.