突发公共卫生事件中的人道主义医药物资分配

发布时间：2018-07-03 15:10

本文选题：人道主义物流 + 应急物流　；参考：《浙江大学》2016年博士论文

【摘要】：突发公共卫生事件不仅危害人民身体健康、导致经济损失,还会对人们造成短期和长期的心理伤害。如何提供可靠、有效、公平的人道主义医药物流至关重要。本文聚焦于突发公共卫生事件，尤其是大规模传染病爆发的情境。在阐述人道主义医药物资分配的重要作用、特殊之处和研究价值的基础上,本文综合分析传染病爆发后的应急物资分配问题,兼顾物资分配的效率性与公平性,建立和求解人道主义医药物资分配模型,以降低突发公共卫生事件造成的损失与伤害。具体而言,本文的主要内容包括：(1)人道主义医药物资的单地区动态分配模型。在需求不确定的环境下,讨论医药物资在时间轴上的分配问题。突发公共卫生事件通常会持续一段时间,并且出于人道主义的原因,某一地区的剩余物资可能会由上级政府进行统一的二次分配而供其它地区使用。因此,一个地区的决策者不能只考虑单一阶段的物资需求,还需要考虑本地物资库存与消耗的动态变化。本文根据传染病的特点,采用动态随机规划方法建立模型。每个时间阶段的初始库存大小会受到之前阶段的物资分配量与随机需求量的影响,而医药物资的随机需求的分布函数也随时间变化。在这一部分也对如何具体化医药物资需求的概率密度函数和累积分布函数进行了说明。此外,本文也建立了一个相应的静态随机规划模型,用以比较静态模型和动态模型的异同。在建模的基础上,本章给出了最优解的解析形式,并对其性质加以分析。最后,采用数值分析进一步理解其在管理实践上的价值。(2)人道主义医药物资的多地区分配模型。在假设需求可以预测的基础上,提出了一个多地区的物资分配的基本模型。该模型包括往复进行的两个部分：(a)随时间变化的医药物资需求的预测。本文根据传染病的传播规律,提出了一个经过修正的易感-潜伏-传染-治愈(SEIR)模型来预测每个疫区的医药物资需求。考虑到脆弱型人群的传染率、死亡率、治愈率通常与普通型人群不同,模型充分体现了脆弱型人群和普通型人群之间的差异,提高了预测的准确率。(b)物资分配决策。根据需求预测的结果,建立线性规划模型,将其应用于多出救点、多需求地的物资分配问题。在此基础上,本文又提出两个扩展模型,以增强模型解决实际问题的能力。本文首先扩展需求预测部分,考虑多个疫区之间的空间交互关系。其次,通过讨论受影响人群的心理状态对分配决策进行扩展。最后,本文通过一个基于真实数据的案例研究和四个基于实验数据的测试分析,对三个模型进行比较。数值分析的结果说明了模型的可行性和三个模型之间的异同,对管理实践具有借鉴意义。(3)人道主义医药物资分配中的跨部门合作。研究物资配置中的跨部门合作与信息共享问题。典型的人道主义物流活动中的参与部门可以分为两类：公共部门(例如政府部门)和私人部门(例如企业)。本文构建了四种不同合作机制下的随机规划模型,分别是：非合作模型、由政府部门领导的半合作模型、由私人部门领导的半合作模型,以及完全合作模型。在半合作策略下,两个部门能够共享关于目标和约束的相关信息,但各自分别做出物流决策；而在完全合作策略下,政府部门制定决策,但需要向私人部门支付一定补贴以维持合作关系。在建立模型的基础上,本文分别求出了四种模型的最优解的解析表达式、讨论这四种模型的异同,并进一步进行数值分析。解析分析和数值分析结果说明了半合作与完全合作机制分别的潜在优势。本文的重要贡献和创新点包括：(1)开展跨学科的研究,综合应用多种理论和方法,形成比较完整、具有针对性的大规模突发公共卫生事件中的人道主义医药物资分配决策模型。(2)在研究物资在时间轴上的动态分配问题时,建立动态随机规划模型并求得其解析和数值解。建立的模型更符合实际,其最优解的解析形式为实现物资的最优配置提供决策依据。(3)在预测需求时,充分考虑传染病疫情的演化过程和发展规律,并进一步考虑到脆弱型人群的特殊生理特质和疫区之间的空间互动关系,为物资分配决策提供依据。(4)提出决策目标时,不仅考虑疫区居民的生理状态和物资分配的成本,也讨论疫区居民心理情况,以优化生理和心理状态,而不是仅仅物资最多或效率最高为分配决策的目标,更体现人道主义救援中以人为本的特征。(5)研究公共部门与非公共部门合作开展人道主义物资分配的可能性与合作模式,并对不同的模式进行比较。
[Abstract]:Public health emergencies not only harm the health of the people, cause economic losses, but also cause short-term and long-term psychological harm to people. How to provide reliable, effective and fair humanitarian medical logistics is very important. This article focuses on public health emergencies, especially the situation of the outbreak of large-scale infectious diseases. On the basis of the important role, particularity and research value of the distribution of medical materials, this paper comprehensively analyzes the problem of the distribution of emergency materials after the outbreak of infectious diseases, takes into account the efficiency and fairness of material distribution, establishes and solves the distribution model of humanitarian medical materials, so as to reduce the loss and injury caused by the emergency public health events. The main contents of this paper are as follows: (1) a single area dynamic distribution model of humanitarian medical materials. The distribution of medical materials on the timeline is discussed under the uncertainty of demand. Public health emergencies usually last for a period of time, and for reasons of humanitarianism, the surplus material in a certain area may be possible. There will be a unified two allocation by the superior government for use in other areas. Therefore, the decision-makers in a region can not only consider the material needs of a single stage, but also consider the dynamic changes in the inventory and consumption of local materials. Based on the characteristics of infectious diseases, the dynamic random planning method is used to establish the model. The initial stock size will be influenced by the distribution of material and the random demand in the previous stage, and the distribution function of the medical materials' random demand varies with time. In this part, the probability density function and the cumulative distribution function of the medical material demand are explained. The static stochastic programming model is used to compare the similarities and differences between the static model and the dynamic model. On the basis of the modeling, the analytic form of the optimal solution is given and its properties are analyzed. Finally, the value of its management practice is further understood by the numerical analysis. (2) the multi regional distribution model of humanitarian medical materials is assumed. On the basis of the demand prediction, a basic model of material distribution in a multi region is proposed. This model includes two parts of the reciprocation: (a) the prediction of the demand for medical materials with time. In this paper, a modified susceptibility latent infection cure (SEIR) model is proposed to predict each of the spread of infectious diseases. Considering the infection rate, death rate and cure rate of the vulnerable population, the rate of cure is usually different from that of the ordinary people. The model fully embodies the difference between the vulnerable group and the common type, and improves the accuracy of the forecast. (b) the decision of material distribution. The linear programming model is set up according to the result of the demand forecast. On the basis of this, two extended models are proposed to enhance the ability of the model to solve practical problems. In this paper, we first extend the demand prediction part and consider the spatial interaction between the multiple epidemic areas. Secondly, the allocation decision is discussed by discussing the psychological state of the affected population. In the end, this paper compares the three models with a case study based on real data and four tests based on experimental data. The results of the numerical analysis illustrate the feasibility of the model and the similarities and differences between the three models, and are useful for the management practice. (3) the cross part of the distribution of humanitarian medical materials. Cross sectoral cooperation and information sharing in material allocation. The participating sectors in typical humanitarian logistics activities can be divided into two categories: public sectors (such as government departments) and private sectors (such as enterprises). This paper constructs random programming models under four different cooperative mechanisms, namely, non cooperative models, The semi cooperative model led by the government department, the semi cooperative model led by the private sector, and the complete cooperation model. Under the semi cooperative strategy, the two departments can share the relevant information about the target and the constraints, but each makes the logistics decision respectively. Under the complete cooperation strategy, the government departments make decisions, but need to be directed to the private department. The door pays a certain allowance to maintain the cooperative relationship. On the basis of the establishment of the model, the analytic expression of the optimal solution of the four models is obtained. The similarities and differences of the four models are discussed and the numerical analysis is further carried out. The analytical and numerical results show the potential advantages of the semi cooperative and complete cooperation mechanism respectively. The important contributions and innovation points include: (1) to carry out interdisciplinary research and apply a variety of theories and methods to form a relatively complete and targeted public health emergencies decision-making model for the distribution of humanitarian medical materials. (2) dynamic random planning is established in the study of the dynamic distribution of materials on time and time axis. The model and its numerical solution are obtained. The model established is more practical, and the analytical form of the optimal solution provides the decision basis for the optimal allocation of materials. (3) the evolution and development of infectious diseases are fully considered in the prediction of the demand, and the special physiological characteristics of the vulnerable population and the area between the epidemic areas are further considered. The spatial interaction relationship provides the basis for the decision-making of material distribution. (4) when making the decision goal, not only takes into account the physiological state and the cost of the material distribution of the residents in the epidemic area, but also discusses the psychological situation of the residents in the epidemic area, in order to optimize the physiological and psychological state, not only the maximum material or the highest efficiency is the goal of the allocation decision, but also embodies the humanitarian rescue. (5) study the possibility and mode of cooperation between the public sector and the non public sector to carry out the distribution of humanitarian materials, and compare the different models.
【学位授予单位】：浙江大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R197.1

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