[Constituent and workload of service providers engaged in cancer screening: findings and suggestions from a multi-center survey in China].

ABSTRACT

Objective: To understand the constituent and workload of service providers engaged in cancer screening in China and provide evidence for the assessment of the sustainability of national cancer screening project. Methods: Using either questionnaire or online approach, the survey was conducted in 16 provinces, where Cancer Screening Program in Urban China (CanSPUC) was conducted, from 2014 to 2015. The medical institutes surveyed included hospitals [71.1% were class Ⅲ(A) hospitals], centers for disease control and prevention (CDCs) and community centers where cancer screening was undertaken during 2013-2015. The questionnaire survey was conducted among the staffs responsible for the overall coordination, management and implementation of the screening project to collect the information about the allocation, workload and compensation of the service providers from different specialties. Results: A total of 4 626 staffs were surveyed in this study, their average age was (37.7±9.5) years, and males accounted for 31.0%. Human resources allocated differed with province. The number of senior staff ranged from 6 (Chongqing) to 43 (Beijing) among the 8 comparable provinces. Among the staffs surveyed, 2 192 were from hospitals, 431 were from CDCs and 1 990 were from community centers, and the staffs who complained heavy workload accounted for 19.9%, 24.6% and 34.1% respectively (P<0.001). Among 227 staffs for overall coordination, 376 management staffs and 3 908 staffs for implementation, those who complained heavy workload accounted for 23.6%, 22.3% and 28.2% respectively (P<0.001). A total of 3 244 staffs (73.8%) got compensations for heavy workload. The compensation types were manly labor fee linked with workload (67.5%) and labor fee regardless workload (26.6%). Conclusion: The province specific differences in human resources allocation indicated the differences in screening project's organizing pattern and capability. It is suggested to conduct routine cancer screening (using specialized staffs), reduce the workload of the first line and community staffs and increase the compensation for the service providers for the sustainability of cancer screening project in China.