目的 在艾滋病诊疗过程中应用多学科协作模式(MDT),以提升艾滋病学科及传染病专科医院医疗技术水平和医疗服务质量。方法 借助安徽省艾滋病诊疗中心平台,中国科学技术大学附属第一医院(安徽省立医院)感染病院(简称感染病院)在艾滋病门诊和住院诊疗过程中尝试MDT,重点分析实行艾滋病MDT前后抗病毒治疗门诊工作量变化和MDT组47例艾滋病合并外科疾病住院病例资料。结果 通过3年多的探索,感染病院艾滋病抗病毒门诊就诊人次涨幅高达916.88%,艾滋病科住院患者转出率下降82.56%,住院病例组合指数(CMI)上升至0.86,艾滋病科出院患者平均住院日降至14.00 d,其中,MDT组平均住院(10.13±8.22)d,明显优于同期住院治疗组。结论 实行艾滋病MDT后,感染病院在提供“一站式”综合诊疗服务的同时,解决了部分艾滋病合并外科疾病患者住院难、手术难问题。为确保MDT工作的有效开展,国家应给予政策支持和制度保障,各医疗机构应捋顺MDT工作流程、明确职责分工、制定诊疗规范,建立健全MDT相关配套性规章制度,将MDT形式多样化。
Abstract
Objective To apply the multidisciplinary cooperation model in the diagnosis and treatment of AIDS,so as to improve the medical technology level and medical service quality of AIDS disciplines and infectious disease hospitals. Methods With the help of the platform of AIDS diagnosis and treatment center in Anhui Province,the First Affiliated Hospital of USTC (Division of Life Sciences and Medicine,University of Science and Technology of China),tried the multidisciplinary collaboration (MDT) model in the process of AIDS outpatient and inpatient diagnosis and treatment,focusing on the analysis of the changes in the workload of antiviral treatment outpatient before and after the implementation of AIDS MDT and the case data of 47 AIDS inpatients with surgical diseases in the MDT group. Results Through more than three years of exploration,the number of AIDS antiviral outpatients in infectious hospitals increased by 916.88%,the transfer rate of AIDS inpatients decreased by 82.56%,the case mix index (CMI) increased to 0.86,and the average length of stay of all discharged AIDS patients decreased to 14.00 days.Among them,the average length of stay in the MDT group was (10.13 ± 8.22) days,which was significantly better than that in the in-patients in the same period. Conclusion After the implementation of the multidisciplinary model of AIDS in the infection hospital,while providing "one-stop" comprehensive diagnosis and treatment services,it has solved the problems of difficult hospitalization and surgery of some patients with AIDS complicated with surgical diseases.To ensure the effective implementation of MDT work,the government should provide policy support and institutional guarantees.Medical institutions should streamline the MDT work process,clarify the division of responsibilities,develop diagnostic and treatment standards,establish and improve supporting rules and regulations related to MDT,and diversify the forms of MDT.
关键词
多学科协作 /
艾滋病 /
应用效果
Key words
Multidisciplinary collaboration /
AIDS /
Effect
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