北京生物醫(yī)學(xué)工程

可變預(yù)約時(shí)段的柔性預(yù)約機(jī)制仿真

Simulation on flexible appointment mechanism with varied appointment time slot

作者：黃益槐項(xiàng)薇彭俊韓樂(lè)琦吳成宇

單位：寧波大學(xué)機(jī)械工程與力學(xué)學(xué)院（浙江寧波 315211）寧波大學(xué)先進(jìn)儲(chǔ)能技術(shù)與裝備研究院（浙江寧波 315211）

關(guān)鍵詞：預(yù)約時(shí)段； Simio仿真；分時(shí)段；服務(wù)時(shí)間不確定；失約

分類號(hào)：R318.04

出版年·卷·期（頁(yè)碼）：2021·40·3（279-287）

摘要：

目的針對(duì)預(yù)約就診中的不確定性，從可變分時(shí)段預(yù)約視角研究分析柔性預(yù)約方法以提高醫(yī)護(hù)資源效率。方法提出一種新的柔性交錯(cuò)預(yù)約時(shí)段策略，通過(guò)Simio仿真平臺(tái)構(gòu)建考慮負(fù)荷、醫(yī)生服務(wù)時(shí)間偏差及失約等不確定性的柔性預(yù)約時(shí)段模型，仿真分析在不同情境下可變交錯(cuò)時(shí)段對(duì)系統(tǒng)成本、患者等待時(shí)間、醫(yī)生加班時(shí)間和空閑時(shí)間等指標(biāo)的變化規(guī)律。結(jié)果分時(shí)段預(yù)約策略較步入式能降低患者平均等待時(shí)間48.85%；在高負(fù)荷與正常負(fù)荷情境，采取適當(dāng)正向交錯(cuò)率預(yù)約時(shí)段策略能改進(jìn)預(yù)約系統(tǒng)評(píng)價(jià)指標(biāo)，尤其在高負(fù)荷高服務(wù)時(shí)間偏差下正向交錯(cuò)率預(yù)約時(shí)段策略效果最佳；最后考慮在不同失約率下，發(fā)現(xiàn)最優(yōu)交錯(cuò)率預(yù)約時(shí)段策略隨著失約率增加由正向交錯(cuò)率變?yōu)樨?fù)向交錯(cuò)率策略。結(jié)論仿真結(jié)果可為分時(shí)段預(yù)約調(diào)度提供參考，在不同情境下給出相應(yīng)柔性交錯(cuò)率策略推薦，為醫(yī)院決策提供量化基礎(chǔ)。

Objective In order to improve the efficiency of medical resources, this paper analyzes a variable flexible appointment time method from the perspective of time appointments. Methods A new flexible overlapping appointment time slot strategy is proposed. Then we use the simio simulation platform to build a flexible appointment period simulation model of different load rates, service time deviations and patients’ no-show rates. The changing rules on the overlapping rate to the system cost, patient waiting time, doctor overtime and free time. Results The numerical experiments show that the time-division strategy can reduce the average waiting time of patients by 48.85% compared with the walk-in strategy. Under high-load and normal-load, adopting the positive overlapping rate appointment strategy can improve appointment system evaluation index. Especially under high load and high service time deviation, the positive overlapping rate appointment strategy works best. Comparing the different no-show rates, the optimal overlapping rate appointment strategy gradually shifts from positive to negative strategies as the no-show rate increases. Conclusions The best flexible appointment strategy recommendation is given to provide a quantitative basis in different situation for hospital decision-making.

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