多阶段医疗系统下病人滞留分析与应用

连续治疗(continuity of care)逐渐成为评价医疗系统质量的一个重要指标,而现实中由于下一阶段无可用资源导致已完成当前阶段服务的病人滞留现象频繁发生.现有文献通常假定病人在滞留期间处于等待状态,实地研究却表明病人滞留期间会继续接受下一阶段治疗服务,且上下阶段的服务时长存在相关性.基于此,建立考虑病人连续治疗的排队模型,设计滞留可能性估计算法.与仿真结果及其它相关算法比较,新建算法具有更高准确性与稳定性.此外,对新建算法的扩展应用证明其在评价医疗系统性能与优化医疗资源配置上效果显著.

The blocking analysis and application of patients in multistage health care system

Continuity of care has become an important indicator of the quality of healthcare gradually, however, patients are frequently blocked at the present stage in reality due to insufficient capacity at the next stage. Existing papers on such blocking problem assume that patients just wait in the blocking period, while filed survey in hospital prove that patients accept the service of next stage when they are blocked, and the corresponding service time between neighboring stages is related. Under the consideration of continuity of care, a queuing model and a more effective heuristic on estimating blocking probability are designed. Compared with simulation results and previous approaches, new heuristic is more accurate and stable. In addition, expanded applications of the new heuristic prove it's effectiveness in health care performance evaluation and resource allocation.