国家消化系统肿瘤多学科诊疗试点项目推广效果分析  

Analysis on the promotion effect of the national multi-disciplinary team diagnosis and treatment pilot project of digestive system tumors

作　　者：王丹[1] 薛冬[1] 唐洪磊 申占龙[3] 叶颖江[3] 沈琳[1] 陆明[1] Wang Dan;Xue Dong;Tang Honglei;Shen Zhanlong;Ye Yingjiang;Shen Lin;Lu Ming(Medical Services Department of Peking University Cancer Hospital&Beijing Institute for Cance Research,Key Laboratory of Carcinogenesis and Translational Research of Ministry of Education,Beijing 100142,China;Evidence-based Medicine Branch of Guangdong Medical Association,Guangzhou 510180,China;Department of Gastrointestinal Surgery of Peking University People's Hospital,Surgical Oncology Laboratory of Peking University People's Hospital,Beijing Key Laboratory of Colorectal Cancer Diagnosis and Treatment,Beijing 100044,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所医务处,恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142 [2]广东省医学会循证医学分会,广州510180 [3]北京大学人民医院胃肠外科,北京大学人民医院外科肿瘤研究室,北京市结直肠癌诊疗研究重点实验室,北京100044

出　　处：《中华医院管理杂志》2022年第5期362-366,共5页Chinese Journal of Hospital Administration

摘　　要：目的分析国家消化系统肿瘤多学科协作诊疗(multi-disciplinary team,MDT)试点项目进展和推广效果,为推进肿瘤MDT模式提供依据。方法获取231家消化系统肿瘤MDT试点医院2018年度(2017年7月至2018年6月)、2019年度(2018年7月至2019年6月)和2020年度(2018年7月至2019年6月)MDT项目评估表的数据。分析试点医院开展消化系统肿瘤MDT情况、门诊和住院MDT开展情况、病例分布,以及MDT管理、收费和区域辐射情况。所有数据采用描述性分析和频数分析。结果排除数据缺失的试点医院,2018—2020年度纳入分析的试点医院数量分别为227家、224家和224家。开展消化系统肿瘤MDT的试点医院从2018年度的174家提升至2020年度的222家;门诊和住院MDT病例分别从48332例和61823例增长至72493例和106899例;实施MDT管理制度的试点医院从159家提升至214家。2020年度,门诊和住院MDT均次费用均以200~500元为主;135家(60.3%)试点医院是区域内MDT主导医院。结论我国消化系统肿瘤MDT试点项目取得了明显成效,开展MDT的试点医院数量逐年增长,且试点医院在区域内起到一定引领作用。为加快推广肿瘤MDT模式,笔者建议医院应针对MDT进一步提高患者可及性、优化管理模式、推进医保报销、加强区域辐射作用。Objective To analyze the progress and promotion effect of the national multidisciplinary team(MDT)pilot project of digestive system tumor diagnosis and treatment,for the reference in promoting the popularition of tumor MDT model.Methods The data of MDT project evaluation forms of 231 digestive system tumor MDT pilot hospitals in 2018(July 2017 to June 2018),2019(July 2018 to June 2019)and 2020(July 2018 to June 2019)were obtained.The MDT of digestive system tumors,the development of outpatient and inpatient MDT,the distribution of cases,and the management,charging and regional radiation of MDT in the pilot hospital were analyzed.Descriptive analysis and frequency analysis were used for all the data.Results With pilot hospitals of missing data excluded,the number of pilot hospitals included in the analysis from 2018 to 2020 was 227,224 and 224,respectively.The number of pilot hospitals carrying out digestive system tumor MDT increased from 174 in 2018 to 222 in 2020,the number of outpatient and inpatient MDT cases increased from 48332 and 61823 to 72493 and 106899 respectively,and the proportion of pilot hospitals implementing the MDT management system increased from 159 to 214.In 2020,the average expenses of outpatient and inpatient MDT were mainly 200-500 yuan,and 135(60.3%)pilot hospitals became the leading MDT hospitals in the region.Conclusions The MDT pilot project of digestive system tumors in China has achieved remarkable results.For example,the number of pilot hospitals carrying out MDT keeps increasing year by year,and the pilot hospitals have played a leading role in the region.In order to accelerate the coverage of the tumor MDT model,the authors suggested that the hospitals should optimize MDT in terms of patient accessibility,optimize management mode,promote the medical insurance reimbursement,and strengthen regional influence.

关 键 词：消化系统肿瘤 多学科协作诊疗 试点医院 诊疗模式 效果评价 

分 类 号：R197.323[医药卫生—卫生事业管理]