ORGANIZATIONAL MODELS OF “ONE-STOP” CLINICS FOR THYROID DISEASE: A REVIEW OF PROCESSES, PERFORMANCE INDICATORS, AND OUTCOMES FROM THE LITERATURE

Marko Kimi Milić; Šćepan Sinanović; Dejan Kostić; Milena Ratković

Marko Kimi Milić Visoka medicinska škola strukovnih studija "Milutin Milanković", Beograd https://orcid.org/0009-0007-1308-7220
Šćepan Sinanović Visoka medicinska škola strukovnih studija "Milutin Milanković", Beograd https://orcid.org/0000-0002-8125-7873
Dejan Kostić Univerzitet odbrane u Beogradu, Medicinski fakultet Vojnomedicinske akademije u Beogradu, Beograd, Srbija; Vojnomedicinska akademija u Beogradu, Institut za radiologiju, Beograd, Srbija https://orcid.org/0000-0002-4420-6348
Milena Ratković Vojnomedicinska akademija, Beograd, Srbija

Ključne reči: one-stop klinika; štitasta žlezda; ultrazvuk; fina iglena aspiracija; ROSE; TIRADS; Bethesda; indikatori performansi; zdravstveni menadžment

Sažetak

Pozadina: Fragmentisani putevi zbrinjavanja nodularne bolesti štitaste žlezde produžavaju vreme do odluke i povećavaju troškove. „One-stop“ klinike (OSK) integrišu klinički pregled, ultrazvuk, UZ-vođenu FNA i, po potrebi, ROSE/telecitologiju u jednoj poseti.

Cilj: Mapirati organizacione modele OSK, definisati ključne pokazatelje performansi (KPI) i sumirati ishode (vreme, posete, adekvatnost, ponovljene FNA, troškovi, zadovoljstvo, bezbednost).

Metode: Scoping pregled prema PRISMA-ScR i JBI. Pretražene su MEDLINE, Scopus i Web of Science (2000–avgust 2025). Uključene su studije koje operacionalizuju OSK i/ili izveštavaju KPI/ishode. Ekstrakcija je obuhvatila organizacione karakteristike, protokole (ACR/EU-TIRADS, Bethesda), metrike toka, adekvatnost FNA/ROSE, ekonomiku, zadovoljstvo i bezbednost. Sprovedena je narativna sinteza.

Rezultati: Identifikovani modeli OSK dosledno skraćuju lead-time do odluke i redukuju broj poseta. Adekvatnost uzoraka je visoka, posebno uz ROSE/telecitologiju, što smanjuje ponovne punkcije. Zadovoljstvo pacijenata je visoko; bezbednosni profil FNA ostaje povoljan. Ekonomske analize ukazuju da je isplativost ROSE kontekst-zavisna i najveća pri višoj baznoj neadekvatnosti i/ili nižem trošku. Predložen je KPI paket: lead-time, udeo „jedna poseta“, Bethesda I, udeo ROSE, ponovna FNA ≤90 dana, trošak po epizodi, zadovoljstvo.

Zaključak: OSK su primenljiv i vrednosno orijentisan model za dijagnostiku štitaste žlezde. Selektivna primena ROSE/telecitologije i upravljanje na osnovu KPI omogućavaju efikasnu i bezbednu implementaciju u različitim resursnim okruženjima.

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MODELI ORGANIZACIJE „ONE-STOP“ KLINIKA ZA BOLESTI ŠTITASTE ŽLEZDE: PREGLED PROCESA, INDIKATORA PERFORMANSI I ISHODA IZ LITERATURE

Sažetak

Reference