Policies for Prevention and Control of Oral Cancer in the light of Giddens’ Structuration Theory

Abstract Challenges remain to ensure access to diagnosis and treatment ten years into continuous cancer prevention, control, and oral health policies. This study aims to analyze the oncology and oral health policies in force regarding the process of implanting oral cancer-related care components. Ten policies were analyzed under the lenses of the Structuration Theory, besides data on the supply of services between 2002 and 2017. Low coverage and inadequate regional distribution were highlighted in primary and secondary health care levels, despite increased funding and number of services. Unequal distribution of performed surgeries was identified in tertiary care. The limitation of home care services has hindered users’ access to palliative care. A convergence was identified between the analyzed policies and concern with the regulation of authoritative resources and the increase of allocative resources, which stirred the expansion of services. Investments should be made in the expansion, regionalization, and universalization of services. A possible setback in these policies could aggravate the situation and contribute to the increase in health inequalities.

摘要 历经十余年持续推进的癌症防控与口腔健康政策体系，在保障诊疗服务可及性方面仍存在诸多挑战。本研究以结构化理论（Structuration Theory）为分析视角，结合2002至2017年的服务供给数据，对10项现行肿瘤学与口腔健康政策展开剖析，聚焦口腔癌相关照护要素的落地实施进程。研究发现，尽管资金投入与服务数量均有所提升，但基层与二级医疗卫生机构的服务覆盖率仍偏低、区域分布不均衡；三级医疗环节的手术开展量分布不均问题同样突出，居家护理服务的供给不足则阻碍了服务对象获取姑息治疗。此外，所分析的政策均呈现出对权威资源规制与配置资源扩充的关注，这一共通导向推动了服务规模的扩张。后续应加大投入，推动服务扩容、区域均衡布局与全民覆盖；若这些政策遭遇推进阻滞，可能会加剧当前困境，进一步拉大健康公平性差距。