Abstract: Background　National policies of China have continuously promoted integrated traditional Chinese and Western medicine collaborative diagnosis and treatment in general hospitals, and interdepartmental consultation of the Department of Traditional Chinese Medicine (TCM) serves as the core carrier for interdisciplinary cooperation. Centered on holistic care for elderly patients with multimorbidity, general practice is highly consistent with the holistic syndrome differentiation theory of TCM. Nevertheless, systematic empirical research focusing on targeted interdepartmental consultations between the TCM Department and the General Practice Department remains scarce. Objective　To systematically analyze the disease composition, service models and clinical characteristics of interdepartmental consultations between the department of TCM and the General Practice Department in a general hospital in beijing, and clarify its positioning and value in the hospital's multidisciplinary collaboration. Methods　A retrospective analytical approach was adopted. Complete medical records of 1,929 in-hospital interdepartmental consultations conducted by the TCM Department of a tertiary Grade A general hospital in Beijing from 2022 to 2024 were extracted. Demographic characteristics of patients, departments submitting consultation requests, types of consultation requests, consultation purposes and TCM intervention recommendations were collected and analyzed. The Pareto principle (80/20 rule) was applied to identify major requesting departments, and statistical software was used for statistical analysis of measurement data and enumeration data. Results　From 2022 to 2024, the TCM Department of the studied hospital completed a total of 1,929 interdepartmental consultations, accounting for 4.61% of all hospital-wide consultations. Consultation requests originated from 22 out of 30 eligible clinical departments across the hospital, representing a department coverage rate of 73.33% (22/30). Among consulted patients, 908 were male and 1,021 were female, with a mean age of (68.75±1.41) years old. A total of 1 454 patients were aged over 60 years, accounting for 75.37% of all TCM interdepartmental consultations. The General Practice Department submitted the highest annual and three-year cumulative number of consultation requests, with a total of 554 cases(28.72%). Other major requesting departments included the Department of Respiratory Medicine (332 cases, 17.21%), Department of Neurology(196 cases, 10.16%), Department of Endocrinology (125 cases, 6.48%), General Surgery Department(119 cases, 6.17%), Department of Gastroenterology (105 cases, 5.44%) and Intensive Care Unit (ICU, 72 cases, 3.73%). Collectively, these seven departments contributed less than 80% of all consultation requests; per the Pareto classification criterion, they were defined as the primary departments requesting TCM interdepartmental consultations. Primary underlying diseases of consulted patients covered 18 physiological systems including circulatory, nervous, digestive, respiratory and musculoskeletal systems, involving 69 distinct disease entities. Among the 1 454 consulted patients aged over 60 years between 2022 and 2024, 1,431 had confirmed diagnoses of common chronic geriatric diseases with multimorbidity. The predominant chronic conditions comprised hyperlipidemia, coronary heart disease, hypertension, type 2 diabetes mellitus, osteoporosis, cerebral infarction and chronic pulmonary diseases. Conclusion　The General Practice Department constitutes the primary requester of TCM interdepartmental consultations in general hospitals. The core population served by the collaboration between the two departments consists of elderly patients of advanced age with multimorbidity, with predominant application scenarios in long-term management of chronic geriatric diseases and perioperative rehabilitation conditioning. However, the hospital-wide coverage of TCM consultation services is insufficient. A regularized collaborative mechanism between general practice and TCM should be established. TCM-advantaged disease categories need to be clearly defined, and clinical application scenarios for TCM consultations should be expanded. Such measures can fully exploit the strengths of integrated traditional Chinese and Western medicine in the integrated management of geriatric multimorbidity, and provide practical evidence for the high-quality development of traditional Chinese medicine services in general hospitals.

Key words: Consultation, Department of Traditional Chinese Medicine, Department of general practice, Hospitals, general, Development strategy

摘要： 背景　国家政策持续推动综合医院中西医协同诊疗，中医科间会诊是两学科协作核心载体。全科医学以老年共病全人管理为核心，与中医整体辨证理念高度契合，但针对中医科与全科医学科定向会诊的系统性实证研究较少。目的　系统分析北京市某综合医院中医科与全科医学科间会诊的疾病构成、服务模式及临床特征，明确其在院内多学科协作中的定位与价值。方法　采用回顾性分析方法，提取2022—2024年北京市某三级甲等综合医院中医科完成的1 929例院内科间会诊完整记录，收集分析患者人口学特征、会诊申请科室、会诊申请类型、会诊目的及会诊处理意见。采用二八法则识别主要申请科室，并使用统计软件对计量资料和计数资料进行统计分析。结果　2022—2024年案例医院中医学科完成科间会诊总工作量为1 929例，占全院会诊量的4.61%（41 843例）。共涉及22个科室申请会诊，全院共有30个科室可以申请会诊，覆盖率73.33%（22/30）。会诊患者中男908例、女1 021例，平均年龄（68.75±1.41）岁。其中>60岁1 454例，占中医科间会诊总量的75.37%。申请中医科间会诊的科室以全科医学科每年申请量最高，且3年合计构成比最高，共计554例（28.72%）。呼吸内科332例（17.21%），神经内科196例（10.16%），内分泌科125例（6.48%），普通外科119例（6.17%），消化内科105例（5.44%），ICU 72例（3.73%），以上科室3年累计构成比<80%，依据二八分类原则，以上7个科室是申请中医科间会诊的主要科室。会诊病症的原发疾病共涉及循环系统、神经系统、消化系统、呼吸系统、骨骼系统等18个系统，69个病种。2022—2024年案例医院中医科间会诊60岁以上患者1 454例，其中1 431例住院诊断存在老年常见慢性病，并存在多病共存情况，老年常见慢性病主要以高脂血症、冠心病、高血压病、2型糖尿病、骨质疏松、脑梗死、慢性肺部疾病为主。结论　全科医学科是综合医院中医科会诊最主要需求科室，两科协作核心服务人群为高龄多病共存老年患者，优势场景集中于老年慢性病长期管理等；但中医会诊全院覆盖度不足，疾病应用范围较窄。需建立常态化全科与中医协作机制，明确中医优势病种，拓宽中医会诊临床应用场景，充分发挥中西医协同在老年共病一体化管理中的作用，为综合医院中医药高质量发展提供实践依据。

关键词: 会诊；中医科；全科医学科；医院, 综合；发展策略