Liao Chun-Ming, Kung Pei-Tseng, Wang Yueh-Hsin, Tsai Wen-Chen
Department of Public Health, China Medical University Department of Pharmacy, China Medical University Hospital Department of Healthcare Administration, Asia University Department of Health Services Administration, China Medical University, Taichung, Taiwan.
Medicine (Baltimore). 2017 Jun;96(23):e7092. doi: 10.1097/MD.0000000000007092.
The literature describing the effectiveness of multidisciplinary team (MDT) for the care of colorectal cancer remains unclear. We investigated the effects of MDT care on the quality of colorectal cancer treatment, and the emergency department visit number was used as an indicator. In total, 45,418 patients newly diagnosed with colorectal cancer from the Taiwan National Health Insurance Research Database (2005-2009) were included. Propensity score matching with a ratio of 1:3 was adopted to reduce differences in characteristics between MDT care participants and non-MDT care participants. After matching, 3039 participation MDT care groups and 9117 nonparticipation groups were included and analyzed with χ and t tests, determine the distribution was similar. Without the control of variables, the percentage difference between participation and nonparticipation MDT care groups in utilization of emergency care was 0.03% (P > .05). The logistic regression model involving controlled variables demonstrated that odds ratio (OR) by probability of emergency care used for participation MDT care groups within a year of cancer diagnosis was less than that for nonparticipation (OR = 0.87, 95% confidence interval: 0.78-0.96). Large amount data were used and confirmed significant benefits of MDT in colorectal cancer care.
关于多学科团队（MDT）对结直肠癌护理有效性的文献尚不明确。我们调查了MDT护理对结直肠癌治疗质量的影响，并将急诊就诊次数作为一项指标。总共纳入了来自台湾国民健康保险研究数据库（2005 - 2009年）的45418例新诊断的结直肠癌患者。采用1:3的倾向评分匹配法来减少MDT护理参与者与非MDT护理参与者之间的特征差异。匹配后，纳入3039个MDT护理参与组和9117个非参与组，并通过χ检验和t检验进行分析，确定分布相似。在未控制变量的情况下，MDT护理参与组与非参与组在急诊护理利用方面的百分比差异为0.03%（P>0.05）。涉及控制变量的逻辑回归模型表明，癌症诊断后一年内MDT护理参与组使用急诊护理的概率的优势比（OR）低于非参与组（OR = 0.87，95%置信区间：0.78 - 0.96）。使用了大量数据并证实了MDT在结直肠癌护理中的显著益处。
