肿瘤专科医疗联合体发展存在的问题与对策研究

A Study on the Problems and Countermeasures of the Development of Tumor Specialized Medical Consortium

目的:研究肿瘤专科医疗联合体(以下简称“医联体”)发展中存在的问题并提出对策建议,为肿瘤专科医联体高质量发展提供参考。方法:采用目的抽样方法,选取来自上海、江苏、浙江、湖北6家公立医院的15名从事肿瘤专科医联体工作的专家进行半结构式访谈,并运用Colaizzi现象学资料7步分析法对访谈资料进行分析。结果:访谈资料共提炼出7大主题,分别是医联体内远程医疗服务定价不利于提升医患参与度、双向转诊的流程与机制不够顺畅、成员单位对远程教学与进修培训的意愿强烈、学科共建与科研合作不够密切、癌症预防筛查工作与基层社区医院的联系不足、缺乏绩效考核与激励机制、宣传不到位与沟通交流不畅等。结论:7大主题可归纳到诊疗、教学、科研、预防、管理5大方面,反映出肿瘤专科医联体发展所面临的主要问题,建议完善双向转诊与远程会诊;加强线下进修与线上远程教学;加强科研合作与学科建设;联合基层医疗机构开展早癌筛查;完善绩效考核与宣传交流,推动紧密型医联体建设。

Objective:Investigate the issues present in the development of the cancer specialist medical consortium and propose strategic recommendations,to provide references for the high-quality development of the cancer specialist medical consortium.Methods:Using purposive sampling,15 experts engaged in specialized cancer medical consortium work were selected from six public hospitals in Shanghai,Jiangsu,Zhejiang,and Hubei.Semi-structured interviews were conducted focusing on consortium cooperation content,supporting management measures,and policy support.The interview data was analyzed using Colaizzi's phenomenological seven-step method.Results:The interview data yielded seven major themes:remote medical service pricing not conducive to increasing patient participation,the referral process and mechanism not smooth enough,a strong willingness for remote teaching and further training,insufficient closeness in joint academic building and scientific research cooperation,inadequate connection between cancer prevention screening work and grassroots community hospitals,lack of performance assessment and incentive mechanisms,insufficient publicity,and communication barriers.Conclusion:Seven major themes can be summarized into five key aspects:treatment,education,research,prevention,and management,reflecting the main challenges faced in the development of the cancer specialist medical consortium.It is recommended to improve two-way referral and remote consultation;strengthen offline further study and online remote teaching;enhance scientific research cooperation and subject construction;collaborate with community hospitals to carry out early cancer screening;and improve performance evaluation,publicity,and communication,to promote the construction of a closely integrated medical consortium.