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论文编号：	12427
作者编号：	2120192792
上传时间：	2021/6/10 21:15:14
中文题目：	考虑病人随机因素的可加号门诊预约调度策略研究
英文题目：	Study on the Scheduling Strategy of the Additional Number of Outpatient Appointments considering the Random Factors of the Patients
指导老师：	梁峰
中文关键字：	马尔可夫过程；门诊调度；爽约；取消预约；可加号；收益管理
英文关键字：	Markov process; outpatient scheduling; missed appointment; cancel appointment; outpatient service can be added; revenue management
中文摘要：	门诊作为病人在医院就诊的开始，合理的门诊调度方式对医院的高效运转具有重要价值。在现实门诊预约系统服务实施中，门诊服务开始时期，经常出现预约病人取消预约或病人爽约的情况，不仅占据了其他病人的门诊号源，还造成了医疗资源的浪费，导致号源分配出现波动，出现病人、医院和社会效益的三重损失。为改善各大医院运营效率及管理质量，并提高病人的就诊满意度，我国各大医院已在不断完善门诊预约服务，但在实际过程中，推进门诊全预约方式尚有阻碍，仍需要探索考虑门诊可加号情况下，不同类别的病人在随机因素下对医院门诊综合收益的影响，及实施过程中的优化方法，协同打造良好的医疗服务生态。 本文从不同类别病人以及不同的预约方式出发，考虑门诊可加号对医院门诊接受病人预约请求决策的影响角度。为了给整体病人更好的服务体验、更高的满意度，考虑综合收益，文章以收益管理理论为方法基础，用马尔可夫过程模型模拟了各大医院门诊的预约以及服务开始的过程。首先分析普通医师号源，门诊可以加号对医院收益及决策的影响，将病人分成三类，建立基于马尔可夫决策过程的门诊预约调度模型（MDP-OA），分析出最佳收益及最优加号决策。然后在此基础上，考虑到提前预约病人可以取消预约的情况，分析门诊最优决策；最后，考虑专家医师提供门诊号源，病人可能爽约且服务中会出现急诊病人插队的情况，提出预约病人之间的最优能力分配策略，建立模型并证明对于任意的提前预约时段，存在提前预约病人的最佳数量，给出了确定数量的精确算法；通过数值算例说明了提出的能力分配策略的有效性。 本文得出如下结论：在医生可看诊号源数小、医疗资源紧张，或是在病人需求量大、医院供不应求时，MDP-OA决策策略比传统的先到先得策略表现的优越，有助于提高病人满意度，合理配置号源并减少医生加班时间，实现综合收益最优；宣传强调采用取消预约代替无故爽约，增设警示提醒；实行预付费预约，加强病人预约约束，设置奖惩手段，实现医疗资源的合理配置，该模型也可用于银行、美容沙龙等可取消预约的情形；对插队的急诊病人实行差异化、优先级分类，对于提高病人的满意度、增大门诊综合期望收益有显著作用。
英文摘要：	Outpatient clinics are the initial link of the hospital's consultation process, and reasonable outpatient scheduling methods are of great value to the efficient operation of the hospital. During the implementation of the outpatient scheduling strategy service, the situation of scheduled patients canceling their appointments before the outpatient day or breaking their appointments on the day of the outpatient clinic often occurs, which not only affects the success rate of other patients' appointments, but also may cause a waste of hospital outpatient resources, resulting in patients, hospitals and other patients loss of social benefits. In order to improve the operational efficiency and management quality of major hospitals, and increase patient satisfaction, major hospitals in my country have continuously improved their outpatient appointment services. However, in the actual process, there are still obstacles to promoting the full appointment of outpatient clinics, which still needs to be explored and considered. Under the condition that the outpatient department can be added, the impact of different types of patients on the comprehensive income of the hospital outpatient department under random factors, and the optimization methods in the implementation process, coordinate to create a good medical service ecology. This thesis starts from different types of patients and different appointment methods, and considers the influence of the outpatient service on the decision of accepting patient appointment requests in the outpatient department of the hospital. In order to give the overall patient a better service experience and higher satisfaction, considering the comprehensive income, the thesis uses the income management theory as the method basis, and uses the Markov process model to simulate the appointment and service start process of major hospitals. Firstly, analyze the source of general physician numbers. Outpatients can be added to the hospital's revenue and decision-making. The patients are divided into three categories, and the Markov-Outpatient Scheduling (MDP-OA) discrete process is used to analyze the best revenue and optimal plus decision. Then, on this basis, considering the situation that the patients who booked in advance can cancel the appointment, analyze the optimal decision of the outpatient service; finally, consider that the expert physician provides the outpatient number source, the patient may miss the appointment and the emergency patient jumps in the line during the service, and the patient is requested to make an appointment. Establish a model and prove that for any advance appointment period, there is an optimal number of patients in advance, and an accurate algorithm for determining the number is given. A numerical example is used to illustrate the proposed ability allocation strategy. Effectiveness. This thesis draws the following conclusions: When the number of doctors' available consultation numbers is small, medical resources are in short supply, or when the demand for patients is large and hospitals are in short supply, the MDP-OA decision-making strategy performs better than the traditional first-come-first-served strategy. Helps improve patient satisfaction, rationally allocate account numbers and reduce doctors’ overtime hours to achieve the best overall income; strengthen appointment promotion and advocate timely cancellation of appointments when appointments cannot be made; implement pre-paid appointments, strengthen patient appointment constraints, and set rewards and punishments , to realize the reasonable allocation of medical resources, the model can also be used in banks, beauty salons and other situations where appointments can be cancelled; differentiated and prioritized for emergency patients who jump in the queue, to improve patient satisfaction and increase the comprehensive expected return of outpatients has a significant effect.
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