[1]杨凌鹤刘美岑曹曼温中一廖子锐刘远立.我国三级肿瘤医院多学科诊疗模式开展现状调查[J].中国卫生质量管理,2022,29(10):040-44.[doi:10.13912/j.cnki.chqm.2022.29.10.09 ]
　YANG Linghe,LIU Meicen,CAO Man.Multi-Disciplinary Team Model in China's Tertiary Tumor Hospitals: A Cross-Sectional Investigation[J].Chinese Health Quality Management,2022,29(10):040-44.[doi:10.13912/j.cnki.chqm.2022.29.10.09 ]
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我国三级肿瘤医院多学科诊疗模式开展现状调查
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《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R]

卷:
第29卷
期数:
2022年10期
页码:
040-44
栏目:
医疗质量
出版日期:
2022-10-28

文章信息/Info

Title:
Multi-Disciplinary Team Model in China's Tertiary Tumor Hospitals: A Cross-Sectional Investigation
作者:
杨凌鹤刘美岑曹曼温中一廖子锐刘远立
北京协和医学院卫生健康管理政策学院
Author(s):
YANG Linghe; LIU Meicen; CAO Man
School of Health Management and Policy, Peking Union Medical College
关键词:
三级医院; 肿瘤医院; 多学科诊疗; 医疗质量
Keywords:
Tertiary Hospital;  Tumor Hospital;  Multidisciplinary Team;  Medical Quality
分类号:
R197.3；R197.5
DOI:
10.13912/j.cnki.chqm.2022.29.10.09
文献标志码:
A
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1 158.8例，32家确诊为肿瘤的患者例数中位数为22 043.5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。
Abstract:
ObjectiveTo 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.MethodsFrom 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.ResultsThe median number of MDT cases in 32 tertiary tumor hospitals was 1 158.8, the median number of patients diagnosed with tumor in 32 tertiary cancer hospitals was 22 043.5, 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.

参考文献/References:

［1］杨凌鹤,温中一,刘美岑,等.我国40家三级公立医院多学科诊疗模式经验总结［J］.中华医院管理杂志,2021,37(6):505-508. ［2］郑舒文,马建辉,尹世全,等.恶性肿瘤多学科综合诊疗模式的探索［J］.中国肿瘤,2017,26(9):661-664. ［3］孙 湛,杨 丽,邵雨婷,等.多学科诊疗模式现状分析与思考［J］.中国卫生质量管理,2018,25(6):37-40. ［4］高 扬,邵雨辰,苏明珠,等.癌症患者的多学科团队协作诊疗模式研究进展［J］.中国医院管理,2019,39(3):34-37. ［5］王慧敏,王润玲,李素文,等. 综合性医院多学科诊疗模式的实践与思考［J］. 中国农村卫生事业管理,2019,39(10):750-753. ［6］国家卫生计生委办公厅,国家中医药管理局办公室.关于加强肿瘤规范化诊疗管理工作的通知:国卫办医发〔2016〕7号［EB/OL］. （2016-03-01）［2022-02-23］.https://www.waizi.org.cn/law/10118.html?from=singlemessage. ［7］国家卫生和计划生育委员会.关于印发进一步改善医疗服务行动计划（2018-2020年）的通知:国卫医发〔2017〕73号［EB/OL］. （2017-12-29）［2022-02-23］.http://www.8888120.cn/editor/display.php?id=413n4837405d3o3g. ［8］国家卫生和计划生育委员会医政医管局.关于开展肿瘤多学科诊疗试点工作的通知：国卫办医函〔2018〕713号［EB/OL］. （2018-08-21）［2022-02-23］.https://www.sohu.com/a/250947222_441376. ［9］王丹,莫陶欣,薛冬,等.首批国家肿瘤多学科诊疗试点医院情况分析［J］.中国肿瘤,2021,30(5):352-356. ［10］喻文菡,陶红兵,金莉.基于知识图谱的肿瘤MDT研究可视化分析［J］.中国医院管理,2017,37(9):45-47. ［11］李晔雄.恶性肿瘤多学科综合治疗的制度保证［J］.循证医学,2008,8(4):249-251. ［12］李涛.广东省某三甲综合医院多学科协作诊疗模式实施影响因素分析与对策研究［D］. 广州:南方医科大学,2016. ［13］FLEISSIG A,JENKINS V,CATT S,et al.Multidisciplinary teams in cancer care: are they effective in the UK［J］.Lancet Oncol,2006,7(11):935-943. ［14］余松轩,赵 蓉,李贤华,等.上海市医院多学科诊疗模式标准研制与思考［J］.中国卫生质量管理,2021,28(12):14-17. ［15］周亚旭,王春鸣,周 莹,等.医院中层管理人员对学科建设与多学科协作诊疗认知评价研究［J］.中国医院管理,2021,41(10):46-50. ［16］陈晶,李志伟,张艳桥. MDT在肿瘤领域的发展［J］.现代肿瘤医学,2019,27(5):895-899. ［17］杨亚,梁晨,陈桢,等.国内外多学科诊疗模式研究进展分析［J］.中国卫生质量管理,2021,28(2):16-19. ［18］毛一晴，康定鼎，张博文，等. 嵌入性视角下多学科团队诊疗模式案例研究［J］. 中国医院,2022,26(2):53-56 ［19］郭晓培，王平. 北京某医院医患双方对MDT诊疗模式的认知调查［J］. 医院管理论坛, 2021, 38(3): 42-46.

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更新日期/Last Update: 2022-10-28