考虑患者回诊情况下的门诊科室调度优化

摘要

目前国内大型三甲医院最突出的问题就是资源稀缺,这些稀缺资源主要包括手术室、大型检查设备以及门诊科室等,造成患者严重的排队现象,从而导致患者等待时间过长,满意度下降.通过对哈尔滨市某大型医院进行调研,收集相关数据,研究在考虑患者回诊(即患者当天做完各项检查后又回到初次检查的门诊科室)情况下,对医生门诊科室的数量进行调度优化.利用排队论中的动态优先级对排队规则进行限定,同时引入前景理论中的价值函数,确立以最小化患者时间感知不满意度为主要目标,最小化医院运营成本为次要目标的多目标优化问题.并且分析了两个目标的权重参数变化对总体满意度的影响.建立相应的数学模型,利用模拟植物生长算法(plant growth simulation algorithm,简称PGSA)进行算法设计,通过MATLAB进行仿真,得出在有限度优先的排队规则下,能够更大程度的降低患者不满意度,同时保证较低的运营成本,证明了此研究的有效性和可行性.%At present,a most prominent problem in tertiary hospitals in China is the scarcity of resources inclu-ding operating room,large-scale inspection equipment and outpatient departments,etc..It cause a serious queu-ing issue in hospital which can result in patients' waiting for a long time and reducing their satisfaction.In this paper,we do a research about a large hospital in Harbin and collect a lot of relevant data,and our study is the scheduling optimization in outpatient department considering patient's return visit(patient's return visit means the patient does other examinations and then returns to initial outpatient departments).The queuing rules are de-fined by dynamic priority in queuing theory and the value function in the foreground theory.The main goal is to minimize the patient's time perception discontent and the secondary goal is to minimize the hospital operating costs.And we analyze the influence on overall satisfaction given by the change of the two targets' weight parame-ters.We set up corresponding mathematical models and design the plant growth simulation algorithm(PGSA)and then mahe the simulation by MATLAB.The result proves that reasonable physician outpatient department config-uration can effectively reduce patient dissatisfaction and hospital operating costs.