| BackgroundWith the development of China's medical and health undertakings,medical models and the growing demand for health services,the medical institutions'treatment and management level of diseases has been rapidly improved,and the diagnosis and treatment model of diseases has been constantly improved and innovated.In recent years,due to the refinement of clinical specialty,the complexity of disease,and the diversification of medical technology and means,the hospital is actively exploring the medical model to adapt to the new situation of medical advancement and increasing competition in the medical market,breaking the"specialty boundary",enhancing the integration and continuous development of clinical departments in various specialties,and establishing new medicine for patients to meet their health service needs Model-multidisciplinary team(MDT)model came into being.With the advantages of multi-disciplinary cooperation and the concept of patient-centered,this model has attracted the attention of hospital managers.Research at home and abroad shows that MDT mode provides the best diagnosis and treatment scheme for patients through multi-disciplinary integration and intersection,which changes the traditional individual and empirical medical mode,effectively integrates medical resources,maximizes the benefits of diagnosis and treatment,and leads patients to better rehabilitation outcomes.At present,MDT mode has become It is one of the important medical models.External treatment and internal treatment of traditional Chinese medicine constitute a complete treatment system of traditional Chinese medicine.The broad sense of external treatment refers to all the methods of treating diseases in traditional Chinese medicine except for the internal administration of traditional Chinese medicine,including both the theory of internal treatment of traditional Chinese medicine and the advantages of external treatment of traditional Chinese medicine.It has been widely concerned because of its simple operation,precise curative effect and small side effects.Therefore,under the opportunity of medical model innovation,s Hospital of traditional Chinese medicine has carried out multi-disciplinary integrated diagnosis and treatment of external treatment of traditional Chinese medicine in order to give full play to the characteristic advantages of "simplicity,convenience,effectiveness and honesty" of traditional Chinese medicine,actively explore and promote multi-disciplinary integrated diagnosis and treatment services.ObjectiveIn this study,by studying the current situation of s Hospital of traditional Chinese medicine in implementing the multi-disciplinary integrated diagnosis and treatment mode of external treatment of traditional Chinese medicine,the influence of the mode on the difference of inpatient expenses and inpatient days was analyzed;the influencing factors affecting the implementation of the mode were explored,the existing problems were found out,and the relevant improvement suggestions were put forward,so as to provide a reference for other hospitals in developing the multi-disciplinary diagnosis and treatment mode of traditional Chinese medicine.MethodsIn this study,quantitative and qualitative methods are used to collect and analyze data.In the qualitative research,six experts from the Chinese and Western clinical and hospital management of s Hospital of Traditional Chinese Medicine were interviewed in-depth to understand the development,organizational structure and current process of external treatment of Traditional Chinese Medicine under the multidisciplinary integration of external treatment of traditional Chinese medicine.Combined with the experience of experts,the data analysis results were discussed,and the specific reasons for the difference of inpatient expenses and doctors' knowledge,credit and behavior scores were analyzed,and suggestions for improvement were put forward.In the quantitative research,first of all,the questionnaire survey data and the data extracted by his system in the hospital are:data sorting and statistical chart making in excel2016;flow chart making such as technical route and integration of external treatment of Traditional Chinese Medicine by using drawing software such as Visio;statistical analysis by using spss20.0.The basic information characteristics of patients and doctors were analyzed by descriptive analysis.After taking the natural logarithm of hospitalization expenses and days for logarithmic conversion,t-test and one-way ANOVA were carried out first to determine whether there were differences among the classifications of gender,age,medical payment method,admission method and treatment method.Variables with statistical significance were found in the results of t-test and one-way ANOVA In order to judge the influence of factors on length of stay and cost of stay,stepwise multiple linear regression analysis was included.Binary variables were directly included in multiple linear regression analysis,while disordered multiple variables were included in regression analysis in the form of dummy variables.Reliability analysis and exploratory factor analysis were used to test the reliability and validity of the multi-disciplinary integrated knowledge and practice questionnaire of TCM external treatment,and single factor analysis was used The differences of age,gender,Department,education background,professional title and professional field of zhixinxing questionnaire were analyzed by the analysis of prime variance.P<0.05 was statistically significant.Results(1)Through combing the current situation of multidisciplinary integration of TCM External Treatment in s Hospital,it is found that each department of the hospital is actively carrying out external treatment technology,and the hospital manages the mode from related systems,organizational structure,management supervision mechanism and other aspects(2)After taking the natural logarithm of patients' hospitalization days and hospitalization expenses for logarithmic conversion,through single factor analysis and multiple linear regression analysis,it was found that:compared with MDT group without external treatment of TCM,MDT group with external treatment of TCM had less hospitalization days(logarithmic conversion value),which could reduce the hospitalization days(P<0.01),and the difference was statistically significant The difference between the two groups was significant(P<0.01)There is statistical significance.In the treatment mode,the t-test of MDT group and MDT group showed that:Acupuncture cost,MDT group was lower than MDT group(P=0.01);special treatment cost,MDT group was lower than MDT group(P=0.01)Group A(P<0.01)The analysis of variance showed that:the treatment cost of MDT group was lower than that of MDT group,and the test cost of MDT group was lower than that of MDT group(P<0.01)The MDT group and MDT group were lower than MDT group(P<0.01)(3)There were differences in the scores of knowledge,credit and behavior among the surveyed doctors in different ages,departments,education background,professional titles and years of work.Most of the doctors surveyed were aged 30-39 years old,and there were many non-Traditional Chinese Medicine external treatment departments.Most of them had master's degree,and most of them were attending doctors.Their working years were less than 10 years.In the age group,the score of knowledge,attitude and overall score of the 30-39-year-old group is lower than that of the 40-49-year-old group and ? 50-year-old group;in the Department group,the score of knowledge,attitude,behavior and overall score of the TCM external treatment group is higher than that of the non TCM external treatment group;in the education group,the score of the undergraduate group is higher In the graduate group;in the professional title group,the knowledge,attitude and overall score of the attending physician group were lower than that of the chief physician group;in the career years score difference,the knowledge,attitude,behavior and overall score of the<10 years group were lower than that of the 10-19 years group and ? 30 years group.Results:78.21%of the doctors thought that the best time to intervene was "the disease is suitable for TCM treatment and the curative effect is significant",73.72%of the doctors thought that the best time to quit was "the patient's condition is stable and reaches the discharge standard".In view of the advantage of multidisciplinary integration of TCM external treatment,more than 80%of doctors choose to "make better diagnosis and treatment plan","give full play to TCM external treatment characteristic technology","reduce hospitalization cost and hospitalization days".The main internal factors influencing the invitation of TCM External Treatment to participate in multidisciplinary integrated diagnosis and treatment are as follows:"whether the practitioners of TCM external treatment technology have professional qualification" is 96.79%;the second is "the implementation of TCM external treatment doctors' diagnosis and treatment behavior needs to be strengthened" is 91.67%;the third is "the implementation of TCM External Treatment multidisciplinary integrated management mechanism is not in place",87.18%.The main external factors are:66.89%of doctors think that "the social awareness rate of multi-disciplinary integration mode of external treatment of Traditional Chinese Medicine is low";61.49%of doctors think that it is restricted by the traditional medical professional education and treatment methods".Conclusions and suggestionsThis study mainly takes s Hospital of Traditional Chinese Medicine as an example,after analyzing the multi-disciplinary integrated diagnosis and treatment mode of external treatment of Traditional Chinese Medicine implemented by the hospital,the main conclusions are as follows:first,the multi-disciplinary integrated diagnosis and treatment mode of external treatment of Traditional Chinese Medicine carried out by s Hospital of Traditional Chinese Medicine can effectively reduce the hospitalization cost,western medicine cost and treatment cost of patients with cerebral infarction(recovery period),among which the executive group of external treatment department also It can reduce the number of days in hospital and the cost of examination;secondly,doctors are restricted by the traditional medical education and treatment methods,and the low recognition of the multi-disciplinary integrated diagnosis and treatment of Traditional Chinese Medicine and the low awareness of patients may lead to the non participation of patients who are suitable for the diagnosis and treatment mode;thirdly,there may be differences in professional qualifications and irregular diagnosis and treatment behaviors among the external doctors However,there are differences in acupuncture fees,special diagnosis and treatment fees and treatment fees between TCM External Treatment departments and non external treatment departments;in addition,there is a relative lack of TCM external treatment doctors involved,the supervision and management mechanism of the hospital needs to be further implemented,the multi-disciplinary integrated service process of TCM external treatment needs to be further optimized,and the consultation process lacks the support of information auxiliary system.Therefore,in order to further optimize the multi-disciplinary integration model of TCM External Treatment in the future,the following suggestions are proposed(1)Strengthen the cultivation of external treatment talents of traditional Chinese Medicine.(2)Strengthen the propaganda of multi-disciplinary integration of TCM external treatment.(3)We will further improve the mechanism for examination,supervision and management,and standardize the diagnosis and treatment behaviors of the relevant external doctors of traditional Chinese medicine(4)Strengthen the team cooperation and communication between Chinese and Western medicine(5)Establish an effective incentive and assessment mechanism to mobilize enthusiasm.(6)Make clear the diagnosis and treatment plan of the dominant diseases of TCM external treatment,and further optimize the multi-disciplinary service process.(7)We will improve the management platform of the integrated multi-disciplinary information support system for TCM external treatment. |
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