【摘要】：醫(yī)療檢查作為現(xiàn)代醫(yī)學中不可或缺的一個環(huán)節(jié),已在醫(yī)學研究、大數(shù)據(jù)挖掘、智能診斷等領域得到廣泛重視。隨著我國老齡化人口不斷增加及環(huán)境問題的不斷加劇,人民生活水平的進一步提高,醫(yī)療檢查成了老百姓看病取藥的首要環(huán)節(jié)。然而患者年齡結構差異化大,患者自身情況的不確定性,都使得醫(yī)療檢查調(diào)度問題極為復雜化。同時,患者接受檢查的及時與否直接影響患者后續(xù)治療。在醫(yī)療行業(yè),目前還未對醫(yī)療調(diào)度問題給予足夠的重視,尤其是針對結合醫(yī)療器械預防性維護的調(diào)度。如何將患者的檢查數(shù)據(jù)合理化,問題的模型實際化,算法的應用普遍化,是從科學層面解決我國醫(yī)療行業(yè)中"看病慢"問題的有效手段。因此,從醫(yī)療合理化和社會高效化的角度出發(fā),研究醫(yī)療檢查調(diào)度問題,尤其是維護調(diào)度問題,并建立一套科學合理且適用于我國醫(yī)療現(xiàn)狀的調(diào)度模型及算法,具有重大的現(xiàn)實意義和實用價值。患者作為醫(yī)療工作的核心,存在檢查時間的不固定性。本課題參考生產(chǎn)調(diào)度領域中的惡化工件的情況,分析患者檢查時間延誤存在病情加重的現(xiàn)象,提出利用分段函數(shù)描述醫(yī)療檢查過程中的時間;同時由于醫(yī)療器械需要及時展開預防性維護,在考慮上述情況的同時分析了預防性維護對調(diào)度方案的影響。本課題基于患者和設備維護兩個方面出發(fā),開展醫(yī)療檢查調(diào)度研究,更加貼近醫(yī)療實際,使研究更具指導意義。本文主要工作包括以下四個方面:(1)歸納總結出醫(yī)療檢查調(diào)度問題的研究現(xiàn)狀及研究重點,并簡要介紹相應的調(diào)度算法以及各個方法具備的特點及主要應用范圍。通過實際調(diào)查研究發(fā)現(xiàn)在醫(yī)療檢查環(huán)節(jié)中容易出現(xiàn)問題的原因,將患者實際接受醫(yī)療的時間特點形象化,將患者檢查時間用基本檢查時間和懲罰時間兩部分描述。將醫(yī)療檢查器械的預防性維護采用數(shù)學模型進行描述,在構建模型過程中結合實際情況,予以適當約束。(2)分析了懲罰值為惡化階梯函數(shù)的單機醫(yī)療檢查調(diào)度問題,以極小化總懲罰值為目標,提出改進遺傳算法對問題進行求解,并與其它算法進行對比,驗證算法的有效性。(3)將患者的檢查時間及維護時間固定化,研究目標函數(shù)為最小化滯后檢查患者數(shù)量的調(diào)度問題。構建了改進的變鄰域搜索算法,并通過算例說明該算法的實用性及優(yōu)越性。(4)從集成優(yōu)化的角度出發(fā),建立了預防性維護下的含有累積惡化效應的醫(yī)療檢查調(diào)度問題模型及改進模型,并且設計了基于鄰域搜索的遺傳算法對其進行求解。并將求解結果與其他算法進行對比,凸顯算法的優(yōu)越性。
[Abstract]:As an indispensable link in modern medicine, medical examination has been widely paid attention to in the fields of medical research, big data mining, intelligent diagnosis and so on. With the increasing of aging population and environmental problems, and the further improvement of people's living standard, medical examination has become the most important link for the common people to take medicine. However, the difference of age structure of patients and the uncertainty of patient's own situation make the problem of medical examination scheduling extremely complicated. At the same time, the timely examination of patients directly affects the follow-up treatment. At present, medical dispatch problem has not been paid enough attention to in medical industry, especially in combination with preventive maintenance of medical devices. How to rationalize the patient's examination data, the practical model of the problem and the generalization of the algorithm are the effective means to solve the problem of "slow seeing a doctor" in the medical profession of our country from the scientific level. Therefore, from the point of view of medical rationalization and social efficiency, this paper studies the medical inspection scheduling problem, especially the maintenance scheduling problem, and establishes a set of scientific and reasonable scheduling model and algorithm suitable for the current medical situation in China. It has great practical significance and practical value. Patients as the core of medical work, there is uncertainty of the examination time. Referring to the situation of deteriorating workpiece in the field of production scheduling, this paper analyzes the phenomenon that the patient's condition is aggravated in the delay of examination time, and proposes to use the piecewise function to describe the time in the course of medical examination. At the same time, due to the need of preventive maintenance, the influence of preventive maintenance on scheduling scheme is analyzed. Based on the two aspects of patient and equipment maintenance, the research of medical inspection scheduling is carried out, which is closer to the medical practice and makes the research more instructive. The main work of this paper includes the following four aspects: (1) summarize the current research situation and research focus of medical inspection scheduling problem, and briefly introduce the corresponding scheduling algorithm, the characteristics of each method and the main application scope. Through the actual investigation and research, the causes of the problems in the medical examination are found, the time characteristics of the patients' actual medical treatment are visualized, and the time of the patients' examination is described in two parts: the basic examination time and the punishment time. The preventive maintenance of medical examination equipment is described by mathematical model. In the process of constructing the model, appropriate constraints are given according to the actual situation. (2) the scheduling problem of single machine medical examination with the penalty value of worsening step function is analyzed. Aiming at minimizing the total penalty value, an improved genetic algorithm is proposed to solve the problem, which is compared with other algorithms to verify the effectiveness of the algorithm. (3) the patient's inspection time and maintenance time are immobilized. The objective function of this paper is to minimize the number of delay check patients. The improved variable neighborhood search algorithm is constructed, and the practicability and superiority of the algorithm are illustrated by an example. (4) from the angle of integration optimization, The model and improved model of medical inspection scheduling problem with cumulative deterioration effect under preventive maintenance are established, and a genetic algorithm based on neighborhood search is designed to solve the problem. The results are compared with other algorithms to highlight the superiority of the algorithm.
【學位授予單位】：西南交通大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R197.3;TP18

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