Impact of Multidisciplinary Team Decision-Making on Clinical Outcomes and Healthcare Resource Utilization in Tertiary Hospital Settings: A Retrospective Cohort Study

Objective: Multidisciplinary team (MDT) decision-making is widely adopted in tertiary hospitals, yet evidence regarding its impact on clinical outcomes and resource utilization remains inconsistent. This study evaluated the association between MDT participation and clinical outcomes as well as healthcare resource utilization among hospitalized patients in tertiary hospital settings. Methods: This retrospective cohort study analyzed 158,358 adult hospital admissions from January 2020 to December 2024. Patients were categorized into MDT (n=16,202) and non-MDT groups (n=142,156) based on documented multidisciplinary discussions within 7 days before or after admission. Propensity score weighting with inverse probability of treatment weighting was applied to balance baseline characteristics. Primary outcomes included in-hospital mortality, 30-day mortality, and length of stay. Secondary outcomes encompassed readmission rates, complications, and resource utilization metrics. Results: After propensity score adjustment, MDT participation was associated with significantly reduced in-hospital mortality (adjusted OR=0.78, 95% CI: 0.70– 0.87, P< 0.001), 30-day mortality (adjusted HR=0.82, 95% CI: 0.75– 0.90, P< 0.001), 30-day readmission (adjusted OR=0.88, 95% CI: 0.82– 0.94, P< 0.001), and complications (adjusted OR=0.91, 95% CI: 0.86– 0.97, P=0.003). However, MDT involvement was associated with increased resource utilization, including 24% more imaging studies (P< 0.001), 31% more laboratory tests (P< 0.001), longer hospital stays (P< 0.001), and 18% higher total costs (P< 0.001). Conclusion: In this retrospective cohort study, MDT decision-making was associated with improved clinical outcomes but increased healthcare resource consumption. These findings inform hospital policies regarding MDT implementation and resource allocation strategies.