疾病再诊断项目的研究进展与启示

Research progress and enlightenment of medical second opinion program

疾病再诊断是对临床治疗方案进行优化和调整时常用的决策支持工具,对患者的诊断、治疗和预后有重要影响。国际上再诊断项目实践丰富,在提高医疗质量、控制费用增长等方面发挥重要作用。作者通过文献研究法分析整理了疾病再诊断项目的评价研究进展。21世纪以来,再诊断项目的评价研究一直受到学者关注,以美国、荷兰和德国研究居多;该类研究以回顾性研究为主,整体研究质量较高。癌症的再诊断服务评价研究是热点,评价指标涉及多个角度,评价结果总体向好。对再诊断服务项目的评价研究中可在医疗成本费用方面多加关注;建议政府有关部门结合基本国情,可进行再诊断项目在医疗改革中的有益探索。

Medical second opinion is a decision-support tool for ratification or modification of suggested treatment.Second opinion has a critical influence on the diagnosis,treatment and prognosis.The practice of medical second opinion program is rich in practice and plays an important role in improving medical quality and controlling cost growth.The concept of medical second opinion is unfamiliar in China and there are few relevant kinds of research.Searching and collating relevant literature,this study analyzes the research progress on evaluating medical second opinion program.Since 2000,There are always scholars concerning this issue,with the majority of researches in the United States,the Netherlands and Germany;the main research type is retrospective research,and the research quality is high.Cancer is the most popular topic among researches on evaluating medical second opinion program.While evaluating,the indexes are diverse and multi-angle,and the evaluation results are generally good.In the future,scholars may pay more attention to the cost of medical care when evaluating medical second opinion program.Based on the fundamental realities of the country,it is suggested that the government may conduct a useful exploration of medical second opinion program in China’s medical reform.