Availability of Financial and Medical Resources for Screening Providers and Its Impact on Cancer Screening Uptake and Intervention Programs
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Cancer Screening
2.3. Indicators of Financial Resources
2.4. Indicators of Medical Resources
2.5. Indicators of Screening Interventions
2.6. Other Indicators
2.7. Statistical Analysis
3. Results
3.1. Characteristics of Collected Data
3.2. Results of SEM
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A. Regarding Gastric Cancer Screening Participants
Appendix B. The Impact of the Number of Medical Nurses
References
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Gastric Cancer | Lung Cancer | Colorectal Cancer | Breast Cancer | Cervical Cancer | ||||
---|---|---|---|---|---|---|---|---|
Men | Women | Men | Women | Men | Women | |||
Number of Prefectures | n = 47 | n = 47 | n = 47 | n = 47 | n = 47 | n = 47 | n = 47 | n = 47 |
Cancer screening rate (%) | 9.3 (6.8, 11.5) | 7.4 (5.6, 9.4) | 23.2 (13.5, 28.9) | 21.2 (12.8, 27.0) | 20.3 (17.6, 27.8) | 21.2 (17.0, 26.6) | 24.2 (20.6, 28.9) | 26.3 (23.1, 30.3) |
Variables Related to Screening Intervention * | ||||||||
Call (%) | 80.0 (71.6, 90.0) | 79.7 (69.1, 90.0) | 81.5 (74.2, 92.2) | 81.5 (69.5, 88.4) | 81.0 (72.7, 90.0) | |||
Recall (%) | 31.4 (22.1, 52.1) | 28.0 (18.7, 44.9) | 42.1 (28.2, 52.8) | 44.0 (33.3, 55.1) | 44.8 (34.5, 55.6) | |||
Charge-free (%) | 7.0 (3.0, 20.5) | 28.0 (19.3, 45.9) | 11.1 (5.1, 24.5) | 6.3 (0.9, 16.5) | 8.0 (3.2, 20.0) | |||
>0% (n, %) | 38 (80.9) | - | 45 (95.7) | 35 (74.5) | 38 (80.9) | |||
After-hours (%) | 87.0 (80.0, 94.0) | 86.4 (73.7, 92.1) | 87.0 (77.6, 93.1) | 81.8 (62.9, 90.5) | 76.0 (57.4, 89.5) | |||
>median (n, %) | 24 (51) | 24 (51) | 24 (51) | 24 (51) | 24 (51) | |||
Extra-region (%) | 1.7 (0.0, 5.0) | 1.7 (0.0, 5.0) | 0.00 (0.0, 5.2) | 3.1 (0.0, 7.3) | 1.7 (0.0, 5.8) | |||
>0% (n, %) | 24 (51.1) | 24 (51.1) | 22 (46.8) | 31 (66.0) | 24 (51.1) | |||
Modality extension (%) | 15.1 (7.0, 27.8) | 12.5 (4.5, 20.6) | 1.7 (0.0, 7.4) | 80.0 (50.1, 94.7) | 11.1 (7.5, 23.8) | |||
>0% (n, %) | 42 (89.4) | 40 (85.1) | 24 (51.1) | 44 (93.6) | 39 (83.0) | |||
Out of evidence (%) | 90.5 (83.7, 100.0) | 90.5 (83.7, 100.0) | 90.5 (83.7, 100.0) | 90.5 (83.7, 100.0) | 90.5 (83.7, 100.0) | |||
<100% (n, %) | 13 (27.7) | 13 (27.7) | 13 (27.7) | 13 (27.7) | 13 (27.7) | |||
Upper limit (%) | 28.6 (13.5, 52.9) | 13.3 (3.5, 28.8) | 7.3 (2.0, 18.0) | 52.0 (30.2, 67.7) | 29.6 (12.2, 52.0) | |||
>0% (number, %) | - | 36 (76.6) | 36 (76.6) | - | - |
Data Type | Values |
---|---|
Basic Statistics | |
Mean annual household income (103 yen) | 5.2 (4.9, 5.7) |
Population aged ≥ 65 (%) | 25.5 (24.3, 26.6) |
Medical/financial resources | |
Public health expenses (103 yen) | 20.6 (17.5, 22.9) |
General revenue per capita (103 yen) | 246.9 (218.3, 266.7) |
Number of nurses (per 103 people) | 10.3 (8.6, 11.6) |
Number of public health nurses (per 103 people) | 0.5 (0.4, 0.6) |
Number of hospitals and clinics (per 103 people) | 0.9 (0.8, 1.0) |
Number of medical doctors (per 103 people) | 2.4 (2.2, 2.8) |
Latent Factors | Measured Variables | Gastric Cancer | Lung Cancer | Colorectal Cancer | Breast Cancer | Cervical Cancer | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Men | Women | Men | Women | Men | Women | ||||||||||||
Estimate | p-Value | Estimate | p-Value | Estimate | p-Value | Estimate | p-Value | Estimate | p-Value | Estimate | p-Value | Estimate | p-Value | Estimate | p-Value | ||
Latent variable measurement model | |||||||||||||||||
Resource | Number of public health nurses | 0.88 | - | 0.79 | - | 0.82 | - | 0.78 | - | 0.80 | - | 0.79 | - | 0.80 | - | 0.83 | - |
Public health expenses | 0.62 | <0.001 | 0.72 | <0.001 | 0.68 | <0.001 | 0.67 | <0.001 | 0.73 | <0.001 | 0.72 | <0.001 | 0.72 | <0.001 | 0.67 | <0.001 | |
General revenue per capita | 0.87 | <0.001 | 0.96 | <0.001 | 0.91 | <0.001 | 0.94 | <0.001 | 0.95 | <0.001 | 0.97 | <0.001 | 0.95 | <0.001 | 0.91 | <0.001 | |
Policy | Recall | 0.80 | - | 0.66 | - | 0.60 | - | 0.59 | - | 0.74 | - | 0.74 | - | 0.60 | - | 0.53 | - |
Call | 0.55 | 0.002 | 0.35 | 0.02 | 0.80 | 0.001 | 0.80 | 0.001 | 0.73 | <0.001 | 0.74 | 0.005 | 0.54 | <0.001 | 0.61 | <0.001 | |
Set upper limit | −0.90 | 0.002 | −0.77 | 0.005 | −0.47 | 0.014 | −0.43 | 0.025 | |||||||||
No-charge | 0.38 | 0.03 | 0.41 | 0.023 | |||||||||||||
Regressions | |||||||||||||||||
Response variables | Explanatory variables | ||||||||||||||||
Screening rate | Medical/financial resources | 0.58 | 0.003 | ||||||||||||||
Screening interventions | 0.53 | 0.015 | 0.60 | 0.004 | 0.81 | 0.001 | 0.69 | 0.001 | 1.14 | 0.001 | 1.23 | 0.005 | |||||
Annual household income | 0.27 | 0.017 | 0.34 | 0.003 | 0.24 | 0.038 | 0.51 | <0.001 | 0.41 | 0.002 | 0.38 | <0.001 | |||||
Aging rate | −0.31 | 0.021 | −0.40 | 0.029 | −0.70 | <0.001 | −0.93 | <0.001 | |||||||||
Screening interventions | Medical/financial resources | 0.62 | <0.001 | 0.67 | 0.001 | 0.48 | 0.016 | 0.41 | 0.032 | 0.48 | 0.009 | 0.434 | 0.014 | 0.78 | <0.001 | 0.77 | 0.001 |
Resource | Aging rate | 0.73 | <0.001 | 0.82 | <0.001 | 0.75 | <0.001 | 0.84 | <0.001 | 0.74 | <0.001 | 0.821 | <0.001 | 0.83 | <0.001 | 0.85 | <0.001 |
Model fit indices | |||||||||||||||||
GFI | 0.872 | 0.892 | 0.943 | 0.887 | 0.874 | 0.876 | 0.93 | 0.909 | |||||||||
AGFI | 0.738 | 0.78 | 0.87 | 0.789 | 0.717 | 0.753 | 0.85 | 0.782 | |||||||||
SRMR | 0.09 | 0.091 | 0.07 | 0.093 | 0.111 | 0.115 | 0.081 | 0.084 | |||||||||
CFI | 0.955 | 0.946 | 1.000 | 0.937 | 0.904 | 0.890 | 0.945 | 0.917 | |||||||||
RMSEA | 0.087 | 0.095 | <0.001 | 0.096 | 0.134 | 0.144 | 0.102 | 0.149 | |||||||||
χ2 test (p value) | 0.128 | 0.085 | 0.683 | 0.077 | 0.018 | 0.007 | 0.060 | 0.010 |
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Takahashi, K.; Nakamura, S.; Watanabe, K.; Sakaguchi, M.; Narimatsu, H. Availability of Financial and Medical Resources for Screening Providers and Its Impact on Cancer Screening Uptake and Intervention Programs. Int. J. Environ. Res. Public Health 2022, 19, 11477. https://doi.org/10.3390/ijerph191811477
Takahashi K, Nakamura S, Watanabe K, Sakaguchi M, Narimatsu H. Availability of Financial and Medical Resources for Screening Providers and Its Impact on Cancer Screening Uptake and Intervention Programs. International Journal of Environmental Research and Public Health. 2022; 19(18):11477. https://doi.org/10.3390/ijerph191811477
Chicago/Turabian StyleTakahashi, Koshi, Sho Nakamura, Kaname Watanabe, Masahiko Sakaguchi, and Hiroto Narimatsu. 2022. "Availability of Financial and Medical Resources for Screening Providers and Its Impact on Cancer Screening Uptake and Intervention Programs" International Journal of Environmental Research and Public Health 19, no. 18: 11477. https://doi.org/10.3390/ijerph191811477