基于流感扩散规律的医疗物资订购与配送排程规划

发布时间：2018-04-26 12:07

本文选题：流感 + 传染病动力学　；参考：《南京理工大学》2017年硕士论文

【摘要】：近年来,随着我国经济的快速发展,外出人口流动频繁、人口老龄化、高危人群比例不断增加,流感的危害及其监测和防治的重要性逐步引起了各级政府的高度重视。在流感扩散期间,市场上普通的药品对流感的治疗效果并不明显,患者须到医院接受针对性抗病病毒药品治疗,这将会给医院及配送中心的药品库存管理带来巨大挑战。一方面如果医院相关药品库存过多,将会占用大量流动资金,而且存在大量的药品过期风险;另一方面,如果库存过低,那么可能造成患者不能及时得到治疗,造成医疗服务水平的降低,继而引发更大的经济损失。因此,面对每年的流感肆虐,一个有针对性且紧致化的药品订购与配送规划就显得很重要。基于此,本文以流感扩散环境下的医疗物资订购与配送规划为研究内容,首先建立人口流动情形下的流感扩散动力学模型,找出其扩散的关键控制参数,继而构建出药品时变需求预测模型;其次,从需求驱动和容量约束的角度,研究流感患者的整体指派优化行为,在考虑药品生产商的生产能力、以及药品储备分销中心的订购决策行为等因素基础上,构建药品采购与供应协调优化模型;第三,将上述问题中的"流感患者的整体指派优化行为"这一限制条件放松,考虑患者随机分配到各医院的情形下,应如何订购与配送医疗物资,使得整体运营成本最小;在上述工作的基础上,本文进一步对模型进行拓展,将固定量的订购决策改变为优化模型中的一个决策变量,探究在该环境下的药品采购与供应协调优化模型,以及最优订购量的变化情况。通过研究发现:(1)流感疫情的疾病传播率与恢复率对患者人数的变化影响较大,继而对医疗物资订购与配送的总物流成本影响较大,决策者应该对该参数给予重点关注;(2)患者整体指派的情形在各种条件下均比随机指派情形要优,但这并不能证明其实际应用价值最好,原因在于整体指派情形前提条件比较理想化,相比而言,随机指派情形下的医疗物资订购与配送模式更适合流感这类常见的非应急疫情应对问题,患者对医院的随机选择也更符合现实的情况;(3)当固定订购量改为决策变量时,最优订购量会随着药品需求变化而变化,与固定的订购量相比,非固定的订购决策更能满足实际的需求,并且降低整体运营成本,因此在实际运营过程中,应根据流感疫情的发展趋势,开展小批量多批次的非固定订货决策,更有利于整体物流运营成本的控制。
[Abstract]:In recent years, with the rapid development of China's economy, frequent migration of the population, aging population, increasing proportion of high-risk population, the harm of influenza and the importance of monitoring and prevention have gradually attracted the attention of governments at all levels. During the period of influenza spread, the effect of common drugs on the treatment of influenza is not obvious, patients have to go to hospital to receive targeted anti-virus drugs, which will bring great challenges to the drug inventory management in hospitals and distribution centers. On the one hand, if the hospital has too many drugs in stock, it will occupy a large amount of liquid capital, and there will be a large number of risks of drug expiration; on the other hand, if the stock is too low, then patients may not be able to get treatment in time. The level of medical services reduced, and then led to greater economic losses. Therefore, in the face of the annual influenza epidemic, a targeted and tight drug ordering and distribution planning is very important. Based on this, this paper takes the ordering and distribution planning of medical materials in the environment of influenza diffusion as the research content. Firstly, the dynamic model of influenza diffusion under the condition of population flow is established, and the key control parameters of the influenza diffusion are found out. Secondly, from the point of view of demand-driven and capacity constraints, we study the overall assignment optimization behavior of influenza patients, and consider the production capacity of drug manufacturers. On the basis of the ordering decision behavior of drug reserve distribution center, the optimization model of drug purchase and supply coordination is constructed. Thirdly, the restriction of "the overall assignment optimization behavior of influenza patients" mentioned above is relaxed. How to order and distribute medical materials to make the overall operating cost minimum when patients are randomly assigned to each hospital. On the basis of the above work, this paper further expands the model. The order decision of fixed quantity is changed into a decision variable in the optimization model to explore the optimal model of drug purchase and supply under this environment and the change of the optimal order quantity. Through the study, we found that the disease transmission rate and recovery rate of the influenza epidemic situation have a great influence on the number of patients, and then on the total logistics cost of medical materials ordering and distribution. Decision makers should focus on this parameter.) the overall assignment of patients is superior to that of random assignment under various conditions, but it does not prove to be of the best practical value. The reason is that the premise of the overall assignment situation is more idealized. In contrast, the medical materials ordering and distribution model under the random assignment situation is more suitable for the common non-emergency epidemic response problems such as influenza. Patients' random selection of hospitals is also more in line with the actual situation. When the fixed order quantity is changed to a decision variable, the optimal order quantity will change with the change of drug demand, compared with the fixed order quantity. The non-fixed ordering decision can meet the actual demand better and reduce the overall operating cost. Therefore, in the actual operation process, according to the development trend of influenza epidemic situation, we should carry out small batch and multi-batch non-fixed ordering decision. More conducive to the overall logistics operation cost control.
【学位授予单位】：南京理工大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R95;F274

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