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多学科内分泌诊所对患者和外科医生是否有益?

Can a Multidisciplinary Endocrine Clinic be Beneficial for Patients and Surgeons?

机构信息

Department of Surgery, University of Alabama at Birmingham, Birmingham, AL.

出版信息

Am Surg. 2023 Dec;89(12):5501-5504. doi: 10.1177/00031348231157870. Epub 2023 Feb 16.

Abstract

BACKGROUND

Multidisciplinary clinics are expected to improve patient care by enhancing efficiency for both patients and care providers. We hypothesized that while these clinics are an efficient use of time for patients, they can limit a surgeon's productivity.

METHODS

A retrospective review was performed for patients evaluated in a Multidisciplinary Endocrine Tumor Clinic (MDETC) and Multidisciplinary Thyroid Cancer Clinic (MDTCC) from 2018 to 2021. Time from evaluation to surgery and prevalence of surgery were evaluated. Patients were compared to those evaluated in a surgeon-only endocrine surgery clinic (ESC) from 2017 to 2021. Chi-square and t-tests were used to test significance.

RESULTS

Patients referred to the ESC underwent surgery more often than those referred to either multidisciplinary clinic (ESC 79.5%, MDETC 24.6%, MDTCC 7%; < .001) but had a significantly longer delay between appointment and operation (ESC 19.9 days, MDETC 3.3 days, MDTCC 16.4 days; < .001). Patients had a longer wait from referral to appointment for the MDCs (ESC 22.6 days, MDETC: 44.5, MDTCC 33; < .05). There was no significant difference in miles traveled by patients to any clinic.

CONCLUSION

Multidisciplinary clinics can provide fewer appointments and faster time to surgery for patients but may lead to longer wait time from referral to appointment and fewer overall surgeries than endocrine surgeon-only clinics.

摘要

背景

多学科诊所有望通过提高患者和医护人员的效率来改善患者的护理。我们假设,虽然这些诊所对患者来说是一种高效的利用时间的方式,但它们可能会限制外科医生的生产力。

方法

对 2018 年至 2021 年在多学科内分泌肿瘤诊所(MDETC)和多学科甲状腺癌诊所(MDTCC)接受评估的患者进行了回顾性研究。评估了从评估到手术的时间和手术的发生率。将这些患者与 2017 年至 2021 年在仅外科医生内分泌手术诊所(ESC)接受评估的患者进行比较。使用卡方检验和 t 检验来检验显著性。

结果

转至 ESC 的患者接受手术的比例明显高于转至多学科诊所的患者(ESC 79.5%,MDETC 24.6%,MDTCC 7%;<0.001),但预约和手术之间的时间间隔明显延长(ESC 19.9 天,MDETC 3.3 天,MDTCC 16.4 天;<0.001)。MDC 患者的预约等待时间更长(ESC 22.6 天,MDETC:44.5 天,MDTCC 33 天;<0.05)。任何诊所的患者出行距离都没有显著差异。

结论

多学科诊所可以为患者提供更少的预约和更快的手术时间,但可能会导致从转介到预约的等待时间延长,以及总体手术数量减少,而不是只有内分泌外科医生的诊所。

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