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张晓晗, 胡尚英, 赵方辉, 周彩虹. 中国宫颈癌筛查服务政策量化分析[J]. 中国公共卫生. DOI: 10.11847/zgggws1143537
引用本文: 张晓晗, 胡尚英, 赵方辉, 周彩虹. 中国宫颈癌筛查服务政策量化分析[J]. 中国公共卫生. DOI: 10.11847/zgggws1143537
ZHANG Xiaohan, HU Shangying, ZHAO Fanghui, ZHOU Caihong. Cervical cancer screening service policies in China, 2006 – 2023: a quantitative analysis of government documents[J]. Chinese Journal of Public Health. DOI: 10.11847/zgggws1143537
Citation: ZHANG Xiaohan, HU Shangying, ZHAO Fanghui, ZHOU Caihong. Cervical cancer screening service policies in China, 2006 – 2023: a quantitative analysis of government documents[J]. Chinese Journal of Public Health. DOI: 10.11847/zgggws1143537

中国宫颈癌筛查服务政策量化分析

Cervical cancer screening service policies in China, 2006 – 2023: a quantitative analysis of government documents

  • 摘要:
    目的 分析中国宫颈癌筛查服务政策的内容与不足,为后续优化宫颈癌筛查服务政策体系提供建议。
    方法 收集中国政府网、国家卫生健康委、中国疾病预防控制中心等官网以及北大法宝数据库等平台2006年1月1日 — 2023年5月31日发布的宫颈癌筛查服务相关政策文件,采用内容分析法构建“政策工具 – 政策目标 – 政策力度”三维框架对国家层面颁布的宫颈癌筛查服务政策文件进行量化分析。
    结果 本研究共纳入37份宫颈癌筛查服务相关政策文件,政策工具维度编码174条,其中环境型政策工具使用最多(50.57%),需求型政策工具使用最少(14.95%),无政府采购和医保支付等子工具;政策目标维度编码149条,其中健全筛查长效工作机制占比最大(52.34%);政策力度平均分数为2.54分,我国现行宫颈癌筛查服务相关政策文件基本以“通知”等非立法性文件形式发布, ≥ 4分的政策文件仅占21.62%且条款较少涉及宫颈癌筛查服务。政策工具、目标和力度的交叉分析结果显示,在政策工具维度中,环境型政策工具政策力度最大(2.83分),需求型和供给型政策工具分别为2.47分和2.33分;在政策目标维度中,除推动信息化管理的政策力度最低(2.00分)外,其他目标的政策力度分布相对均衡,均在2.59分上下浮动。
    结论 中国宫颈癌筛查服务政策工具内部结构不均衡,政策目标结构有待优化,不同政策主体对宫颈癌筛查服务政策使用工具和关注点侧重不同,部门间协作不足,应进一步加强政策顶层设计以推进我国宫颈癌筛查服务政策的落地实施。

     

    Abstract:
    Objective To analyze the content and shortcomings of policy documents for cervical cancer screening service issued by government agencies in China and to provide suggestions for optimizing policies for cervical cancer screening service in the future.
    Methods We retrieved policy documents on cervical cancer screening services issued by government agencies from 2006 to 2023 through official websites such as the Chinese Government Network, the National Health Commission of China, the Chinese Center for Disease Control and Prevention, and platforms such as the PKULaw database. Content analysis was used to construct a three-dimensional policy instrument – policy objective – policy strength framework for quantitative analysis of national-level cervical cancer screening policy documents.
    Results This study included 37 policy documents related to cervical cancer screening services, with 174 policy items coded. Among them, the policy items for cervical cancer screening service environment were mentioned most (50.57% of all coded items), and the items for government objective were mentioned least (14.95%), and no items were mentioned for cancer screening service-related government procurement and medical insurance payment. A total of 149 items for cancer screening service-related administrative objective were coded, among which the proportion of items for optimizing the long-term operation mechanism of screening is the highest (52.34%). The average policy strength score for all retrieved documents is 2.54. The analyzed policy documents are mainly issued in the form of non-legislative documents, such as notices. Policy documents with a strength score of ≥ 4 points account for only 21.62% of all documents, and there are few items related to cervical cancer screening services in the documents. In terms of the three dimensions of the documents, the mean strength score (2.83) was highest for policies on the operating environment of screening services, followed by 2.47 for those on government objective and 2.33 for those on provision; on the aspect of government objective, the lowest strength score (2.00) was for policies on promoting relevant information management; the strength scores fluctuated around 2.59 for policies on other aspects related to screening services.
    Conclusion The internal structure of policy instruments for cervical cancer screening services in China is uneven, and the structure of policy objectives needs to be optimized. Different policy units have different focuses on the implementation and concern for cervical cancer screening services, and there is insufficient cooperation among different departments. Therefore, it is necessary to further strengthen the top-level policy design to promote the implementation of cervical cancer screening services in China.

     

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