创新公立医院多学科联合会诊服务供给模式  

Innovation the supply mode of multidisciplinary team care in public hospital

作　　者：李琴[1] 孙爱娟[1] 龚力[1] 谭明英[1] 杨利[1] 龙婷[1] 

机构地区：[1]四川大学华西医院,成都市武侯区国学巷37号610041

出　　处：《中国医院》2017年第8期42-44,共3页Chinese Hospitals

摘　　要：目的:为推进分级医疗,更好地履行国家对公立医院的功能定位,提高医院多学科联合会诊服务工作。方法:对医院2013-2015年多学科联合会诊服务中心2331例患者信息,采用卡方检验及趋势卡方检验进行资料分析,总结医院创新多学科联合会诊服务供给模式,会诊后通过随访疗效及满意度评价。结果:3年中医院多学科联合门诊患者数呈逐年增加势态,不同年度多学科会诊患者的年龄分布差异有统计学意义(χ~2=22.57,P=0.001)。申请多学科联合门诊目的:要求明确诊断664例(28.5%);诊断已明确寻求治疗方案1667例(71.5%)。会诊后随访治疗效果:痊愈418例(17.9%);好转1473例(63.2%);无明显改善123例(5.3%);死亡37例(1.6%);失去随访280例(12.0%)。医院多学科联合会诊中心病种数量逐年增加,且不同年度间多学科联合门诊病种数量差异有统计学意义(χ~2=746.44,P<0.001)。不同年度患者对多学科联合会诊的满意度差异有统计学意义,并呈逐年上升趋势,从2013年的90.1%增加到2015年的97.1%(χ~2=30.51,P_(fortrend)<0.001)。结论:优化多学科联合会诊服务供给模式,有效推动了双向转诊、分级诊疗和区域医疗协作;拓展了医院疑难重症医疗、教学和科学研究工作。Objectives： To promote the hierarchical healthcare system, full play the role of public hospitals and improve multiple discipline team work. Methods： 2331 cases of multiple discipline care in West China Hospital during the year of 2013-2015 were selected to have a chi square test and trend chi square test. The practice of multiple discipline care in West China Hospital were summarized and the patient satisfaction rate were also compared. Results： The number of multidisciplinary outpatient in hospital was increasing year by year. There was a statistically significant difference in multidisciplinary team in the age distribution of patients in different years（χ2=22.57, P=0.001）. The purpose of multidisciplinary outpatient for diagnosis was 664 cases（28.5%）.The multidisciplinary outpatient which the diagnosis was clear and wanted to seek treatment was 1667 cases（71.5%）. The effect of treatment after consultation showed that 418 cases（17.9%） cured, 1473 cases（63.2%） improved, 123 cases（5.3%） no significant improvement, 37 cases（1.6%） dead and 280 cases（12%） lost to follow-up. The number of multidisciplinary diseases in our hospital increased year by year, and there was a significant difference in multidisciplinary outpatient diseases in different years（χ2=746.44, P〈0.001）. There was a significant difference in the satisfaction with multidisciplinary outpatient. And the satisfaction was increasing year by year, increased from 90.1% in 2013 to 97.1% in 2015（χ2=30.51, P〈0.001）. Conclusions： The optimization of the multiple disciplinary care helps promoting the dual referral, hierarchical healthcare and the collaboration of regional healthcare provision and improving intensive care, teaching and work as well.

关 键 词：公立医院 多学科联合会诊 供给模式 分级诊疗 

分 类 号：R197.3[医药卫生—卫生事业管理]