基于史密斯模型的我国三级肿瘤医院多学科诊疗模式执行问题研究

Study on the Implementation of Multi-disciplinary Diagnosis and Treatment Model in China’s Tertiary Cancer Hospitals Based on Smith Model

目的探讨我国三级肿瘤医院多学科诊疗(multidisciplinary diagnosis and treatment,MDT)模式执行问题。方法运用史密斯模型,从理想化政策、执行机构、目标群体以及环境因素分析我国三级肿瘤医院MDT模式执行现状。结果在推动医院高质量发展的大形势下,我国三级肿瘤医院MDT模式得到迅速发展,但仍处在试点阶段,相关制度欠缺相应的配套政策和措施,患者缺乏对MDT模式的全面认知等。结论基于存在的问题,建议行政部门加强对MDT的规范和监管;制定合理的收费标准,并将MDT收费项目纳入医保;推动实施由医院行政主导的MDT管理模式;依托医疗联合体建设、医院联盟等,大力发展网络MDT工作。

Objective Explore the implementation of the multidisciplinary diagnosis and treatment(MDT)model in tertiary cancer hospitals in China.Methods Smith model was used to analyze the implementation status of the MDT model in China’s tertiary cancer hospitals from the perspective of idealized policies,executive agencies,target groups,and environmental factors.Results In promoting the high-quality development of hospitals,the MDT model of tertiary cancer hospitals in China has developed rapidly,but there are still many problems.Conclusion Based on the existing problems,it is suggested that the administrative department strengthen the regulation and supervision of MDT;Formulate reasonable charging standards and incorporate MDT charging items into medical insurance;Promote the implementation of MDT management mode led by hospital administration;Rely on the construction of hospital consortium and hospital alliances,it will vigorously develop the network MDT work.