综合医院以全科医学科为核心的多病共存多学科诊疗门诊的探索实践  

Exploration and practice of multidisciplinary outpatient services for comorbidities with general practice as the core in a general hospital

作　　者：肖幸[1] 薛峥[1] 胡琦[1] 廖鑫[1] 丁玲 黄帅文 周洪莲[1] Xiao Xing;Xue Zheng;Hu Qi;Liao Xin;Ding Ling;Huang Shuaiwen;Zhou Honglian(Department of General Practice,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院全科医学科,武汉430030

出　　处：《中华全科医师杂志》2025年第2期212-215,共4页Chinese Journal of General Practitioners

基　　金：湖北省卫生健康委临床医学教育教学改革研究项目(HBJG-220076);华中科技大学同济医学院第二临床学院教学研究项目(2022065)。

摘　　要：伴随人口老龄化趋势,多病共存(共病)患者日益增多,并成为综合医院全科医学科的重点诊疗对象。华中科技大学同济医学院附属同济医院探索建立以全科医学科为核心的共病多学科门诊诊疗模式,改善了共病患者的诊疗效果,提升了就医体验和满意度。文章阐述全科共病多学科诊疗门诊的组织架构、团队组建、运行流程,并对就诊患者特征和实施效果进行了分析,为其他综合医院全科医学科开展共病诊疗提供参考。With the trend of population aging,the number of patients with comorbidities is increasing,who are the main subjects of general practice service in general hospitals.Tongji Hospital created a new service model and opened a multidisciplinary outpatient clinic based on general practice department(MDT general practic clinic)for patients with comorbidities in December 2021,which has improved the clinical outcomes,and the medical experience and satisfaction of patients.This article elaborates on the organizational structure,team building,and operational process of the MDT general practice clinic for comorbidities;analyzes the characteristics of patients and the implementation effects,to provide a reference for comorbidity patient service in general hospitals.

关 键 词：多病共存 全科医学 多学科 

分 类 号：R47[医药卫生—护理学]