考虑医疗质量差异的医院转诊决策优化  

Optimization of referral decision considering differences in medical quality

作　　者：王伟[1] 李娜[1] WANG Wei;LI Na(School of Mechanical Engineering,Shanghai Jiao Tong University,Shanghai 200240,China)

机构地区：[1]上海交通大学机械与动力工程学院,上海200240

出　　处：《浙江大学学报（工学版）》2021年第7期1261-1269,共9页Journal of Zhejiang University：Engineering Science

基　　金：国家自然科学基金资助项目(71871138,71471114).

摘　　要：为了解决目前医联体中的转诊不当造成的拥堵问题,针对三级医院和社区医院组成的医疗系统,考虑病人流的转移过程,进行排队网络建模.设计基于堵塞时长的迭代算法求解稳态性能参数,建立三级医院的决策优化模型,通过内点法求得最优转诊比例.实验结果表明,优先转诊的病人具有治疗费用低、住院时间长的特点;当医疗质量差异存在时,需要通过优化分析降低病人回流造成的资源浪费.A queuing network model was carried out considering the patients’transfer process,in order to solve the congestion problem caused by improper referral in the current medical consortium,for the medical system composed of a tertiary hospital and community hospitals.Based on the blocktime in the system,an iterative algorithm was designed to solve the steady-state performance parameters,the optimization model of the tertiary hospital was established,the optimal referral ratio was obtained through the interior point method.Experiment results show that transferred patients have the characteristics of low treatment cost and long hospital stay;when there are differences in medical quality,optimization analysis is needed to reduce the waste of resources caused by patient return.

关 键 词：医疗转诊 排队论 迭代算法 马尔可夫链 医疗质量 

分 类 号：C935[经济管理—管理学]