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

【摘要】：隨著我國(guó)經(jīng)濟(jì)的發(fā)展,醫(yī)療問題已經(jīng)成為了人們?cè)絹碓街匾暤膯栴}之一。然而,我國(guó)的醫(yī)療狀況在制度上和服務(wù)上都存在著種種缺陷,例如大型醫(yī)院看病困難且費(fèi)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(zhuǎn)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(guó)各個(gè)地區(qū)的分級(jí)醫(yī)療和雙向轉(zhuǎn)診制度。但同時(shí),這也說明了我國(guó)醫(yī)療聯(lián)合體中的雙向轉(zhuǎn)診制度仍舊存在著許多不足。在分析我國(guó)大型醫(yī)院和社區(qū)醫(yī)療服務(wù)中心之間的雙向轉(zhuǎn)診發(fā)展現(xiàn)狀以及存在的問題的前提下,將我國(guó)醫(yī)療聯(lián)合體中雙向轉(zhuǎn)診中存在的問題分解為大型醫(yī)院中手術(shù)后待康復(fù)的患者向社區(qū)醫(yī)療服務(wù)中心轉(zhuǎn)診、社區(qū)醫(yī)療服務(wù)中心將超出其醫(yī)療能力的重病患者向大型醫(yī)院轉(zhuǎn)診的方式進(jìn)行研究。探討大型由醫(yī)院和社區(qū)醫(yī)療服務(wù)中心利潤(rùn)最大時(shí)的轉(zhuǎn)診率與患者到達(dá)率、患者的排隊(duì)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(zhuǎn)診中由于利潤(rùn)導(dǎo)致的轉(zhuǎn)診不順暢的實(shí)際問題轉(zhuǎn)化為排隊(duì)理論模型,通過矩陣等方式對(duì)排隊(duì)模型進(jìn)行求解。最后,對(duì)患者等待成本不同、單位利潤(rùn)不同、患者到達(dá)率不同時(shí)的情況對(duì)雙向轉(zhuǎn)診中大型醫(yī)院和社區(qū)醫(yī)療服務(wù)中心在利潤(rùn)最大化時(shí)的最優(yōu)轉(zhuǎn)診概率進(jìn)行分析,并提出了在等待成本、單位利潤(rùn)、到達(dá)率不同的情況下大型醫(yī)院和社區(qū)醫(yī)療服務(wù)中心的最優(yōu)轉(zhuǎn)診策略。為大型醫(yī)院和社區(qū)醫(yī)療服務(wù)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(wù)中心能夠自覺自愿的向下和向上轉(zhuǎn)診患者,從而保證我國(guó)醫(yī)療制度中雙向轉(zhuǎn)診制度的有效且順暢的運(yùn)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(xué)位授予單位】：哈爾濱商業(yè)大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R197.1

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