医疗运作管理中三个调度问题的模型与算法研究

发布时间：2021-05-15 18:52

　　面对高昂的医疗费用和日益增长的医疗需求,有效配置医疗资源并提高医疗系统的运作效率变得越来越重要。基于运筹优化方法,本文重点研究了医疗运作管理中的三类问题,即:考虑麻醉复苏室床位有限时的手术调度问题;单个医护团队服务的家庭医疗路径规划和预约调度问题,以及多个医护团队服务的家庭医疗路径规划和预约调度问题。手术病人在完成手术后必须被快速转移到麻醉复苏室进行术后复苏。当麻醉复苏室床位有限时,病人在完成手术后可能会由于复苏室中没有空余的床位而滞留在手术室中,使得后续的手术被延误,手术室的使用效率被降低、医疗团队的加班成本也有可能因此而增加。为此,本文建立了一个两阶段随机规划模型处理麻醉复苏室资源有限下的手术调度问题,并考虑了医疗实践中病人的手术时间和麻醉复苏时间通常是不确定的这一重要特征。该两阶段随机模型中,第一阶段优化手术的分派和排序,第二阶段是一个刻画了随机服务时间的离散事件仿真模型。由于标准的随机规划方法（如L型算法）难以在合理的时间内求解实际规模的问题,本文分析了该模型的若干结构性质,并提出了一个不等式集合以加快算法的收敛速度。基于实际数据的计算机实验表明,本文提出的算法可以在2小时内求... 

【文章来源】：上海交通大学上海市 211工程院校 985工程院校 教育部直属院校

【文章页数】：138 页

【学位级别】：博士

【文章目录】：
摘要
abstract
Chapter 1 Introduction
    1.1 Background
        1.1.1 Health care delivery challenges
        1.1.2 Health care operations management
        1.1.3 Operations research in health care
    1.2 Contributions of This Thesis
Chapter 2 A Stochastic Programming Framework for the Surgery Schedul-ing Problem with PACU Capacity
    2.1 Introduction
    2.2 Problem Description
    2.3 Related Literature
    2.4 Problem Formulations
        2.4.1 A two-stage stochastic programming formulation
        2.4.2 A discrete-event simulation model
    2.5 Solution Approaches
        2.5.1 Accelerating solving the MP
        2.5.2 Speeding up the the convergence
    2.6 Numerical Experiments
        2.6.1 Experimental setup
        2.6.2 Computational performance of the proposed algorithms
        2.6.3 Value of considering the PACU capacity
    2.7 Conclusion
Chapter 3 Home Health Care Routing and Appointment Scheduling withStochastic Service Times
    3.1 Introduction
    3.2 Literature Review
    3.3 Problem Statement and Formulation
    3.4 Integer L-Shaped Method
        3.4.1 The lower bound for Q(x)
    3.5 MTSP Heuristic
    3.6 Limited Information Scenario
    3.7 Computational Experiments
        3.7.1 Implementation of the integer L-shaped method
        3.7.2 Experimental setup
        3.7.3 Computational results
    3.8 Conclusion and Discussion
Appendix
    3.A The Mixed Integer Second Cone Program
Chapter 4 Routing and Appointment Scheduling with Caregiver Assign-ment for Home Health Care
    4.1 Introduction
    4.2 Literature Review
    4.3 Problem Description and Mathematical Model
    4.4 Solution Methodology
        4.4.1 Modified parallel savings algorithm
        4.4.2 Tabu Search method
    4.5 Computational Experiments
        4.5.1 Experiments setup
        4.5.2 Comparative experiments
    4.6 Conclusion and Extension
Appendix
    4.A Additional Comparative Experiment Results
Chapter 5 Summary
    5.1 Conclusion
    5.2 Future Work
Bibliography
Acknowledgements
Research Papers
Projects



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