北京生物醫(yī)學(xué)工程

多目標(biāo)灰靶決策模型在醫(yī)療預(yù)約領(lǐng)域的應(yīng)用研究

Research on the application of multi-object grey target decision model in the field of medical appointment

作者：韓樂琦項薇季孟忠吳成宇黃益槐彭俊

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)儲能技術(shù)與裝備研究院(浙江寧波 315211), 龍游縣檢驗檢測研究院(浙江衢州324400), 溫州職業(yè)技術(shù)學(xué)院(浙江溫州325035),<br />通信作者:項薇。E-mail:[email protected]

關(guān)鍵詞：密集分布;柔性預(yù)約;仿真建模;決策研究;灰色模型

分類號：R318.04:C931

出版年·卷·期（頁碼）：2022·41·4（381-389）

摘要：

目的針對目前國內(nèi)醫(yī)療機(jī)構(gòu)普遍以步入式患者求診為主且存在密集負(fù)荷到達(dá)情況分析混合模式下最優(yōu)預(yù)約及排隊規(guī)則決策，完善門診預(yù)約系統(tǒng)。方法將多目標(biāo)灰靶決策模型引入到柔性預(yù)約中.基于歷史平均人數(shù)2倍人數(shù)2.25倍人數(shù)3種不同負(fù)荷到達(dá)情形實現(xiàn)就診負(fù)荷的均衡化，并仿真驗證該柔性預(yù)約模型的優(yōu)越性。結(jié)果引入柔性預(yù)約模型后，孕婦就診增值比提高，同時從全流程角度可以看出不同負(fù)荷情況等待時間降低77~155min，從均值角度得到平均醫(yī)院停留時間降低率為16.4%~25.3%。結(jié)論柔性預(yù)約模型在患者等待時間、醫(yī)院停留時間等多個評價指標(biāo)下能夠有效改善現(xiàn)有醫(yī)院運(yùn)作狀態(tài)，緩解就診壓力，提高醫(yī)院效率。

Objective In view of the current domestic medical institutions generally focusing on walk-in patient consultations and the presence of intensive load arrivals,the optimal appointment and queuing rule decisions under the hybrid mode are analyzedand the outpatient appointment system is improved.Methods The multi-object grey target decision model is introduced into the flexible appointment,based on the historical average number of people,twice the number of people,and 2.25 times the number of people as different load arrival situations to achieve the balance of the medical load,and the superiority of the flexible appointment model is verified by simulation.Results After the introduction of the flexible appointment modelthe value added ratio of pregnant women’s visits has increased. From the perspective of the whole process,the waiting time under different load conditions is reduced by77min to155min,and the average reduction rate of hospital stay time is 16.4% to 25.3% from the perspective of the average value.Conclusions The flexible appointment mode can effectively improve the operation status of the existing hospital under multiple evaluation indicators such as patient waiting time and hospital stay time,alleviate the hospital visit pressure,and improve the efficiency of the hospital.

參考文獻(xiàn)：

[1] Cayirli T,Veral E. Outpatient scheduling in health care: a
review of literature[J].Production and Operations Management,2009，12(4):519-549.
[2] Ahmadi-Javid A,Jalali Z,Klassen KJ.Outpatient appointment
systems in healthcare: a review of optimization studies [J] European Journal of Operational Research，2017，258(1):3-34.
[3] Gupta D,Denton B.Appointment scheduling in health care:
challenges and opportunities[J]. IIE Transactions，2008，40(9):800-819.
[4] El-Sharo M,Zheng B,Yoon SW,et al. An overbooking
scheduling model for outpatient appointments in a multi-provider clinic[J].Operations Research for Health Care20156:1-10.[5]Peng Y,Qu X,Shi J.A hybrid simulation and genetic algorithm
approach to determine the optimal scheduling templates for open access clinics admitting walk-in patients[J].Computers & Industrial Engineering201472:282-296.
[6] Cayirli T,Dursun P,Gunes ED. An integrated analysis of
capacity allocation and patient scheduling in presence of seasonal walk-ins[J].Flexible Services & Manufacturing Journal，201931:524-561.
[7]吳曉丹,步磊，岳殿民,等.多醫(yī)生單設(shè)備門診排程優(yōu)化[J].
工業(yè)工程與管理，2014，19(4):139-146.
Wu XD，Bu L，Yue DMet al.Outpatient scheduling with multiple providers and single device[J].Industrial Engineering and Management201419(4):139-146.
[8] 潘興薇,耿娜.面向核磁共振檢查的預(yù)約調(diào)度仿真優(yōu)化研究
J1.工業(yè)工程與管理，2016，21(6):17-23.
Pan XW，Geng N.Simulation optimization research on appointment scheduling for MRI examinations[J].Industrial Engineering and Management,2016,21(6):17-23.
[9]李軍，林雪梅，周杰.CT檢查預(yù)約規(guī)則的仿真模擬研究[J].
系統(tǒng)仿真學(xué)報，2018，30(3):976-985,993.
Li J,Lin XM,Zhou J.A simulation study of appointment rules in CT department[J].Journal of System Simulation,201830(3):976-985,993.
[10]秦嵐，徐寅峰.基于滿意度的預(yù)約門診排隊策略研究[J1.運(yùn)
籌與管理，2013.22(2):135-142
Qin L，Xu YF.Research of scheduling outpatient appointments based on patients’satisfactionJ1.Operations Research and Management Science，2013,22(2):135-142 [11]晁永生,孫文磊,袁亮.平行裝配線平衡性的多目標(biāo)優(yōu)化[J].
計算機(jī)集成制造系統(tǒng)2016.22(5):1211-1219.
Chao YS,Sun WL,Yuan L. Parallel assembly line balancing based on multi-objective optimization[J].Computer Integrated Manufacturing Systems，2016，22(5):1211-1219.
[12] Marynissen J,Demeulemeester E. Literature review on multi-
appointment scheduling problems in hospitals[J].European Journal of Operational Research,2019,272(2):407-419.
[13]季孟忠,項薇,彭俊,等,基于負(fù)荷平衡的柔性預(yù)約決策[J1.控
制與決策,2021,36(1):226-233.
Ji MZXiang W,Peng J,et al.Flexible outpatient appointment decision model with loading balance[J]. Control and Decision,2021,36(1):226-233.
[14]于欣，李娜，江志斌.考慮患者失約行為的門診預(yù)約決策研
究綜述[J.工業(yè)工程與管理，2016.21(2):132-137,145. Yu X，Li N,Jiang ZB. A survery on the research of missed appointments’behavior and decisions in health system[J]. Industrial Engineering and Management201621(2):132-137,145.
[15]文劉思峰，胡明禮，JeffreyF，等.灰色系統(tǒng)模型研究進(jìn)展[J].
南京航空航天大學(xué)學(xué)報(英文版),2012.29(2):103-111. Liu SF,Hu ML,Jeffrey F,et al.Progress of grey system models J1.Transactions of Nanjing Universityof Aeronautics anc Astronautics，2012，29(2):103-111.

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