本文選題：流感 + 傳染病動力學　； 參考：《南京理工大學》2017年碩士論文

【摘要】：近年來,隨著我國經濟的快速發(fā)展,外出人口流動頻繁、人口老齡化、高危人群比例不斷增加,流感的危害及其監(jiān)測和防治的重要性逐步引起了各級政府的高度重視。在流感擴散期間,市場上普通的藥品對流感的治療效果并不明顯,患者須到醫(yī)院接受針對性抗病病毒藥品治療,這將會給醫(yī)院及配送中心的藥品庫存管理帶來巨大挑戰(zhàn)。一方面如果醫(yī)院相關藥品庫存過多,將會占用大量流動資金,而且存在大量的藥品過期風險;另一方面,如果庫存過低,那么可能造成患者不能及時得到治療,造成醫(yī)療服務水平的降低,繼而引發(fā)更大的經濟損失。因此,面對每年的流感肆虐,一個有針對性且緊致化的藥品訂購與配送規(guī)劃就顯得很重要�；诖�,本文以流感擴散環(huán)境下的醫(yī)療物資訂購與配送規(guī)劃為研究內容,首先建立人口流動情形下的流感擴散動力學模型,找出其擴散的關鍵控制參數,繼而構建出藥品時變需求預測模型;其次,從需求驅動和容量約束的角度,研究流感患者的整體指派優(yōu)化行為,在考慮藥品生產商的生產能力、以及藥品儲備分銷中心的訂購決策行為等因素基礎上,構建藥品采購與供應協(xié)調優(yōu)化模型;第三,將上述問題中的"流感患者的整體指派優(yōu)化行為"這一限制條件放松,考慮患者隨機分配到各醫(yī)院的情形下,應如何訂購與配送醫(yī)療物資,使得整體運營成本最小;在上述工作的基礎上,本文進一步對模型進行拓展,將固定量的訂購決策改變?yōu)閮?yōu)化模型中的一個決策變量,探究在該環(huán)境下的藥品采購與供應協(xié)調優(yōu)化模型,以及最優(yōu)訂購量的變化情況。通過研究發(fā)現:(1)流感疫情的疾病傳播率與恢復率對患者人數的變化影響較大,繼而對醫(yī)療物資訂購與配送的總物流成本影響較大,決策者應該對該參數給予重點關注;(2)患者整體指派的情形在各種條件下均比隨機指派情形要優(yōu),但這并不能證明其實際應用價值最好,原因在于整體指派情形前提條件比較理想化,相比而言,隨機指派情形下的醫(yī)療物資訂購與配送模式更適合流感這類常見的非應急疫情應對問題,患者對醫(yī)院的隨機選擇也更符合現實的情況;(3)當固定訂購量改為決策變量時,最優(yōu)訂購量會隨著藥品需求變化而變化,與固定的訂購量相比,非固定的訂購決策更能滿足實際的需求,并且降低整體運營成本,因此在實際運營過程中,應根據流感疫情的發(fā)展趨勢,開展小批量多批次的非固定訂貨決策,更有利于整體物流運營成本的控制。
[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.
【學位授予單位】：南京理工大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R95;F274

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