Zhongguo quanke yixue (Nov 2023)
Implementation Status and Strategy Research on the Construction of Clinical Pathways for Diagnosis and Treatment of Medically Unexplained Disease in Community General Practice
Abstract
The diagnosis and treatment level of medically unexplained disease (MUD) in the community is closely related to the overall health service capacity of primary healthcare centers. However, general practitioners are not competent enough to diagnose and treat such diseases as shown in current studies. By combing the historical evolution of the introduction of the clinical pathway model into the field of general practice in China, this paper shows that the application of clinical pathway model in China is in a critical period of transition from simple diseases to complex diseases, and from general hospital specialties to general practice in primary care institutions, which confirms a broad application prospect in the diagnosis and treatment of MUD for clinical pathway model. This paper then summarizes the key bottleneck problems faced by the community general practice clinical pathway in China, which mainly include low recognition of clinical pathway by medical staff, difficulty in selecting types of MUD, and the inconsistency between paper form or simple electronic clinical pathway and the rapid development of medical informatization. It is further proposed on the basis that the construction of clinical pathways for diagnosis and treatment of MUD in the community should be based on general practice thinking as the core, and further exploration should be carried out and taking the clinical decision-making information platform of regional medical coordination as a new mode of clinical pathway by breaking through specialty thinking, focusing on dominant diseases, standardizing community diagnosis coding, etc. This paper provides a certain theoretical basis and strategic ideas for the future construction of clinical pathways for diagnosis and treatment of MUD in community general practice.
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