本文選題：雙向轉診 + 大型醫(yī)院　； 參考：《哈爾濱商業(yè)大學》2017年碩士論文

【摘要】：隨著我國經濟的發(fā)展,醫(yī)療問題已經成為了人們越來越重視的問題之一。然而,我國的醫(yī)療狀況在制度上和服務上都存在著種種缺陷,例如大型醫(yī)院看病困難且費用高一直是人們面臨的重要問題。雖然,醫(yī)療聯(lián)合體中的雙向轉診問題在十三五規(guī)劃得到了高度重視,要求加快和完善我國各個地區(qū)的分級醫(yī)療和雙向轉診制度。但同時,這也說明了我國醫(yī)療聯(lián)合體中的雙向轉診制度仍舊存在著許多不足。在分析我國大型醫(yī)院和社區(qū)醫(yī)療服務中心之間的雙向轉診發(fā)展現(xiàn)狀以及存在的問題的前提下,將我國醫(yī)療聯(lián)合體中雙向轉診中存在的問題分解為大型醫(yī)院中手術后待康復的患者向社區(qū)醫(yī)療服務中心轉診、社區(qū)醫(yī)療服務中心將超出其醫(yī)療能力的重病患者向大型醫(yī)院轉診的方式進行研究。探討大型由醫(yī)院和社區(qū)醫(yī)療服務中心利潤最大時的轉診率與患者到達率、患者的排隊等待的懲罰成本、醫(yī)院的資源利用率和損耗等的因素的影響特性。把雙向轉診中由于利潤導致的轉診不順暢的實際問題轉化為排隊理論模型,通過矩陣等方式對排隊模型進行求解。最后,對患者等待成本不同、單位利潤不同、患者到達率不同時的情況對雙向轉診中大型醫(yī)院和社區(qū)醫(yī)療服務中心在利潤最大化時的最優(yōu)轉診概率進行分析,并提出了在等待成本、單位利潤、到達率不同的情況下大型醫(yī)院和社區(qū)醫(yī)療服務中心的最優(yōu)轉診策略。為大型醫(yī)院和社區(qū)醫(yī)療服務中心提供理論依據(jù)和決策參考,讓大型醫(yī)院和社區(qū)醫(yī)療服務中心能夠自覺自愿的向下和向上轉診患者,從而保證我國醫(yī)療制度中雙向轉診制度的有效且順暢的運行。
[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.
【學位授予單位】：哈爾濱商業(yè)大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R197.1

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本文編號：2100115