本文關(guān)鍵詞：醫(yī)院門診預(yù)約系統(tǒng)的優(yōu)化分析：基于國內(nèi)某大型醫(yī)院的研究　出處：《中國科學(xué)技術(shù)大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 醫(yī)院門診預(yù)約系統(tǒng) 預(yù)約模式 分時段預(yù)約 序貫決策

【摘要】：隨著經(jīng)濟(jì)的發(fā)展,人們對醫(yī)療健康服務(wù)的質(zhì)量和效率也愈發(fā)關(guān)注。由于人口基數(shù)龐大以及老齡化的日益加重,人們對于優(yōu)質(zhì)醫(yī)療資源的需求也日益增加。優(yōu)質(zhì)醫(yī)療資源供不應(yīng)求以及得不到有效利用是國內(nèi)大型公立醫(yī)院所面臨的問題。盡管醫(yī)院已經(jīng)實(shí)施了預(yù)約掛號的就診方式,但醫(yī)院的一些熱門科室還是會出現(xiàn)大排長龍的現(xiàn)象。長時間的等待與短暫的就診時間,造成病人對醫(yī)院產(chǎn)生不滿。醫(yī)生工作負(fù)擔(dān)的增加導(dǎo)致醫(yī)院在管理運(yùn)營上的費(fèi)用也在增長。因此,對預(yù)約系統(tǒng)的設(shè)計(jì)研究從現(xiàn)實(shí)上來說是十分必要。本文是以國內(nèi)大型醫(yī)院的門診預(yù)約系統(tǒng)為主要研究對象,深入剖析醫(yī)院的預(yù)約系統(tǒng)在實(shí)際運(yùn)營中所產(chǎn)生的問題。在系統(tǒng)的實(shí)際運(yùn)行過程中,不確定的需求、隨機(jī)的服務(wù)時間、預(yù)約患者爽約行為以及未預(yù)約患者的隨機(jī)到達(dá)等因素都有可能會打亂醫(yī)院原有的預(yù)約安排,增加病人的等待時間,引起醫(yī)生不必要的加班和空閑時間。為了減少這些因素對預(yù)約系統(tǒng)的影響,醫(yī)院需要對即將接收的病人進(jìn)行合理安排。本課題為了應(yīng)對上述不確定因素所帶來的不良影響,對門診預(yù)約調(diào)度方法進(jìn)行了研究。本文的主要研究工作如下:(1)門診預(yù)約系統(tǒng)的研究概況。通過對國內(nèi)外相關(guān)問題的文獻(xiàn)調(diào)查發(fā)現(xiàn),國外對于預(yù)約系統(tǒng)的調(diào)度問題研究比較系統(tǒng),但對于未預(yù)約患者的研究相對較少。而國內(nèi)由于起步晚,對預(yù)約調(diào)度問題的研究相對于國外還不是很成熟,很多模型都是基于國外研究的基礎(chǔ)上進(jìn)行拓展研究的,適合國內(nèi)醫(yī)院情況的比較少。因此,依托我國現(xiàn)階段醫(yī)院常采用的預(yù)約系統(tǒng),分析現(xiàn)階段國內(nèi)預(yù)約系統(tǒng)所存在的問題和對預(yù)約模型進(jìn)行優(yōu)化使之更適合我國醫(yī)院現(xiàn)階段的情況,是十分具有研究價值和現(xiàn)實(shí)意義的。(2)全預(yù)約的分時段預(yù)約模式和部分預(yù)約的預(yù)約模式的對比。本文針對國內(nèi)常用的兩種預(yù)約方式在爽約率、未預(yù)約病人所占比例以及成本系數(shù)比例等參數(shù)改變的情形下通過數(shù)值實(shí)驗(yàn)進(jìn)行了比對研究,發(fā)現(xiàn)爽約概率對于兩個模式的預(yù)約安排影響比較明顯。當(dāng)爽約率偏低以及空閑時間成本系數(shù)相對較大時,部分預(yù)約模式的表現(xiàn)要比全預(yù)約模式要好。即使當(dāng)爽約率高時,增加未預(yù)約病人所占的比例并不能有效彌補(bǔ)醫(yī)院由于爽約而帶來的損失。(3)帶有臨時需求和爽約行為的分時段預(yù)約模式的研究。基于國內(nèi)大型醫(yī)院的具體情況,本文通過聯(lián)合決策醫(yī)院對預(yù)約病人的調(diào)度安排和對未預(yù)約病人的接收容量以最大化醫(yī)院收益為目標(biāo)建立了序貫性的分時段預(yù)約調(diào)度系統(tǒng),并給出了問題的求解方法。在此模型中,未預(yù)約病人的到達(dá)假設(shè)服從泊松分布,預(yù)約病人的優(yōu)先等級高于未預(yù)約病人,同時段的同類型病人按照先來后到的次序進(jìn)行就診,病人的服務(wù)時間服從指數(shù)分布。通過數(shù)值實(shí)驗(yàn)驗(yàn)證了模型的適用性,并且發(fā)現(xiàn)成本比例系數(shù)對總體收益的影響較大。
[Abstract]:With the development of the economy, people pay more attention to the quality and efficiency of medical health service. Because of the huge population base and the increasing aging, the demand for high quality medical resources is increasing. The shortage of high quality medical resources and the lack of effective utilization are the problems facing large public hospitals in China. Although the hospital has already implemented the appointment registration way of visiting, but some of the hot sections of the hospital still have the phenomenon of long long dragon. For a long time and a short visit, the patient was dissatisfied with the hospital. The increase in the burden of doctors' work has led to the increase in the cost of the hospital in management and operation. Therefore, it is very necessary to study the design of the reservation system in reality. This paper is based on the outpatient appointment system of large hospitals in China as the main research object, and analyzes the problems in the actual operation of the hospital reservation system. In the actual operation process of the system, random arrival factors such as uncertain demand, random Business Hours, appointment Miss behavior patients and patients without reservation are likely to disrupt the original hospital appointment, increase the waiting time of the patient, the doctor caused unnecessary overtime and idle time. In order to reduce the impact of these factors on the reservation system, the hospital needs to make reasonable arrangements for the patients to be received. In order to cope with the adverse effects of the above uncertain factors, this paper studies the outpatient appointment scheduling method. The main research work of this paper is as follows: (1) the survey of the outpatient appointment system. Through literature review on related issues at home and abroad, it is found that the research on scheduling problem of appointment system abroad is relatively systematic, but there is relatively little research on unreserved patients. However, due to the late start, the research on the appointment scheduling problem is not very mature compared with foreign countries. Many models are expanded based on the research abroad, and are suitable for domestic hospitals. Therefore, relying on the appointment system commonly used at present stage in our hospital, it is of great research value and practical significance to analyze the problems existing in the current domestic reservation system and optimize the appointment model to make it more suitable for the current stage of our hospital. (2) the comparison of the fully reserved time interval reservation mode and the reservation mode of the partial reservation. The comparison of numerical experiments for the change of parameter in the case of two kinds of appointment at home, not miss rate appointment proportion and cost coefficient ratio, the probability for the two Miss found mode of appointment obvious effect. When the miss rate is low and the idle time cost coefficient is relatively large, part of the booking mode of the performance is better than full reservation mode. Even when the miss rate is high, increasing the proportion of patients without reservation and cannot effectively make up for the hospital due to miss the loss. (3) the research period of a temporary demand and miss behavior appointment mode. The specific circumstances of the domestic large hospitals based on the joint decision of the hospital appointment schedule and to walk-in patients receiving capacity to maximize the return on the hospital was established in order to time sequential appointment scheduling system, and gives the method of solving the problem. In this model, not the patient's arrival is assumed to be Poisson distribution, priority reservation of patients was higher than that of the patient, the same type of patients at the same time of treatment in accordance with the order of the patient in order of arrival, Business Hours exponential distribution. The applicability of the model is verified by numerical experiments, and it is found that the cost ratio coefficient has a great influence on the overall income.
【學(xué)位授予單位】：中國科學(xué)技術(shù)大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R197.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 潘興薇;耿娜;;面向核磁共振檢查的預(yù)約調(diào)度仿真優(yōu)化研究[J];工業(yè)工程與管理;2016年06期

2 王雪琴;徐英;;多元化門診預(yù)約系統(tǒng)的構(gòu)建與實(shí)施[J];護(hù)理學(xué)報(bào);2016年15期

3 曹萍萍;李銘洋;李旭;霍春輝;;一種面向患者門診預(yù)約滿意的決策方法[J];工業(yè)工程;2016年03期

4 許欣悅;賈小溪;田瑋;高廣穎;;北京市某三甲醫(yī)院實(shí)名制預(yù)約對預(yù)約掛號爽約率的影響[J];醫(yī)學(xué)與社會;2016年06期

5 李秋菊;勝彥婷;李榮;李金莉;任世茹;;實(shí)時付費(fèi)模式對傳統(tǒng)門診預(yù)約掛號方法的改進(jìn)作用研究[J];中國醫(yī)藥;2016年04期

6 陶繼平;黃榮歡;梅枝煌;林子雨;;基于拉格朗日松弛的預(yù)約調(diào)度模型與算法[J];系統(tǒng)工程理論與實(shí)踐;2016年06期

7 曹萍萍;唐加福;姜博文;;多個醫(yī)生環(huán)境下考慮取消預(yù)約的門診預(yù)約策略[J];系統(tǒng)工程學(xué)報(bào);2015年05期

8 王光明;許艷貞;;國內(nèi)門診預(yù)約診療開展現(xiàn)狀及未來發(fā)展趨勢探討[J];中國社會醫(yī)學(xué)雜志;2015年02期

9 羅利;申曉君;嚴(yán)學(xué)勇;陳憲;郭惠利;;病人不守時下的CT檢查預(yù)約仿真與優(yōu)化[J];工業(yè)工程與管理;2015年01期

10 羅利;秦春蓉;羅永;;基于馬爾可夫決策過程的醫(yī)療檢查預(yù)約優(yōu)化模型[J];運(yùn)籌與管理;2014年06期

相關(guān)博士學(xué)位論文 前1條

1 閻崇鈞;門診預(yù)約問題的建模和調(diào)度算法研究[D];東北大學(xué);2014年

，

本文編號：1338548