摘要
目的了解我国三级肿瘤医院多学科诊疗(MDT)模式开展现状,为进一步推广MDT诊疗模式和改善医疗服务质量提供参考。方法2021年1月-3月,第5次“全国改善医疗服务行动第三方评估”项目组在全国30个省(自治区、直辖市)的33家省级三级肿瘤医院对2019年度MDT开展情况进行问卷调查。使用SPSS 25.0软件对数据进行描述性统计和矩阵分析。结果32家MDT开展例数中位数为1158.8例,32家确诊为肿瘤的患者例数中位数为22043.5例,27家MDT诊疗方案依从率中位数为93.8%,31家MDT开展率中位数为3.98%。中部地区三级肿瘤医院MDT开展率中位数和MDT诊疗方案依从率中位数高于东部地区和西部地区的肿瘤医院。MDT开展率和MDT诊疗方案依从率均高的医院共10家,主要分布于中部地区(40.0%)和东部地区(40.0%);MDT开展率和MDT诊疗方案依从率均低的肿瘤医院共11家,主要分布在西部地区(63.6%)。结论我国医疗机构对肿瘤MDT模式探索起步较早,但MDT开展率仍较低,且地区间、院际间MDT诊疗模式发展不平衡。在推广肿瘤MDT诊疗模式过程中,国家层面需建立统一的MDT诊疗规范和标准;医院层面需加强交流与合作,充分利用信息化技术实现资源共享及协同创新,并构建合理的医师绩效激励体系。
Objective To investigate the current status of multidisciplinary team(MDT)model in tertiary tumor hospitals in China,and to provide reference for further promotion of MDT diagnosis and treatment model and improvement of medical service quality.Methods From January to March 2021,the fifth Third Party Evaluation of the National Action to Improve Medical Services was conducted in 33 provincial-level tertiary cancer hospitals in 30 provinces(autonomous regions and municipalities directly under the Central Government)to conduct a questionnaire survey on the status of MDT in 2019.SPSS 25.0 software was used for descriptive statistics and matrix analysis.Results The median number of MDT cases in 32 tertiary tumor hospitals was 1158.8,the median number of patients diagnosed with tumor in 32 tertiary cancer hospitals was 22043.5,and the median compliance rate of MDT treatment plan in 27 tertiary cancer hospitals was 93.8%.The median MDT implementation rate of 31 tertiary cancer hospitals was 3.98%.The median MDT implementation rate and MDT treatment protocol compliance rate of tertiary cancer hospitals in central region were higher than those in eastern region and western region.There were 10 cancer hospitals with high MDT implementation rate and high MDT treatment protocol compliance rate,mostly distributed in central region(40.0%)and eastern region(40.0%).There were 11 cancer hospitals with low MDT implementation rate and low MDT treatment protocol compliance rate,mainly distributed in the western region(63.6%).Conclusion The exploration of tumor MDT mode in Chinese medical institutions started early,but the development rate of MDT is still low,and the development of MDT diagnosis and treatment mode is unbalanced between regions and hospitals.In the process of promoting tumor MDT diagnosis and treatment,unified MDT diagnosis and treatment norms and standards should be established at the national level.At the hospital level,it is necessary to strengthen communication and cooperation,make full use of information technology to realize resource sharing and collaborative innovation,and build a reasonable physician performance incentive system.
作者
杨凌鹤
刘美岑
曹曼
温中一
廖子锐
刘远立
YANG Linghe;LIU Meicen;CAO Man(School of Health Management and Policy,Peking Union Medical College,Beijing,100730,China)
出处
《中国卫生质量管理》
2022年第10期40-44,共5页
Chinese Health Quality Management
基金
国家卫生健康委员会医政医管局委托项目(2020)
中国医学科学院医学与健康科技创新工程项目(2020-I2M-2-016)
中国医学科学院医学与健康科技创新工程重大协同创新项目(2021-12M-1-046)。
关键词
三级医院
肿瘤医院
多学科诊疗
医疗质量
Tertiary Hospital
Tumor Hospital
Multidisciplinary Team
Medical Quality
