基于排队论的双向转诊策略研究

发布时间：2018-07-05 11:51

本文选题：双向转诊 + 大型医院　；参考：《哈尔滨商业大学》2017年硕士论文

【摘要】：随着我国经济的发展,医疗问题已经成为了人们越来越重视的问题之一。然而,我国的医疗状况在制度上和服务上都存在着种种缺陷,例如大型医院看病困难且费用高一直是人们面临的重要问题。虽然,医疗联合体中的双向转诊问题在十三五规划得到了高度重视,要求加快和完善我国各个地区的分级医疗和双向转诊制度。但同时,这也说明了我国医疗联合体中的双向转诊制度仍旧存在着许多不足。在分析我国大型医院和社区医疗服务中心之间的双向转诊发展现状以及存在的问题的前提下,将我国医疗联合体中双向转诊中存在的问题分解为大型医院中手术后待康复的患者向社区医疗服务中心转诊、社区医疗服务中心将超出其医疗能力的重病患者向大型医院转诊的方式进行研究。探讨大型由医院和社区医疗服务中心利润最大时的转诊率与患者到达率、患者的排队等待的惩罚成本、医院的资源利用率和损耗等的因素的影响特性。把双向转诊中由于利润导致的转诊不顺畅的实际问题转化为排队理论模型,通过矩阵等方式对排队模型进行求解。最后,对患者等待成本不同、单位利润不同、患者到达率不同时的情况对双向转诊中大型医院和社区医疗服务中心在利润最大化时的最优转诊概率进行分析,并提出了在等待成本、单位利润、到达率不同的情况下大型医院和社区医疗服务中心的最优转诊策略。为大型医院和社区医疗服务中心提供理论依据和决策参考,让大型医院和社区医疗服务中心能够自觉自愿的向下和向上转诊患者,从而保证我国医疗制度中双向转诊制度的有效且顺畅的运行。
[Abstract]:With the development of economy in our country, medical treatment has become one of the more and more important problems. However, there are many defects in the medical system and service in our country. For example, the difficulty of seeing a doctor in a large hospital and the high cost have always been an important problem that people are facing. Although the two-way referral problem in the medical association has been paid great attention to in the 13th Five-Year Plan, it is necessary to speed up and perfect the classified medical treatment and two-way referral system in various regions of our country. But at the same time, this also shows that there are still many deficiencies in the two-way referral system in medical consortia in our country. On the premise of analyzing the present situation and problems of two-way referral between large hospitals and community medical service centers in China, The problems existing in two-way referral in China's medical consortia are decomposed into the referral of patients in large hospitals to the community medical service center after surgery. Community health care centers will study the referral of critically ill patients beyond their medical capacity to large hospitals. This paper discusses the influence characteristics of the referral rate and patient arrival rate when the profit of large hospitals and community medical service centers are maximum, the penalty cost of patients queuing and waiting, the utilization ratio and wastage of hospital resources and so on. In this paper, the problem of unsmooth referral caused by profit in bidirectional referral is transformed into queuing theory model, and the queuing model is solved by matrix and so on. Finally, the optimal referral probability of large hospitals and community medical service centers in bidirectional referral is analyzed when the profit is maximized by different waiting cost, different unit profit and different arrival rate of patients. The optimal referral strategies of large hospitals and community medical service centers under different waiting costs, unit profits and arrival rates are also proposed. To provide theoretical basis and decision-making reference for large hospitals and community medical service centers, so that large hospitals and community medical service centers can voluntarily turn patients down and up. So as to ensure the effective and smooth operation of the two-way referral system in the medical system of our country.
【学位授予单位】：哈尔滨商业大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R197.1

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