患者就医决策与患者流优化分布建模分析研究

项目名称： 患者就医决策与患者流优化分布建模分析研究

项目编号： No.71301003

项目类型： 青年科学基金项目

立项/批准年度： 2014

项目学科： 管理科学

项目作者： 宋洁

作者单位： 北京大学

项目金额： 20.5万元

中文摘要： 针对当前我国"看病难"，患者流分布不合理的现状，本研究将综合考虑影响患者选择医疗机构进行就诊的三大因素：医疗服务质量、就诊价格和就医等待时间，将其作为政府的激励因素，基于数学建模和量化分析合理优化患者流分布。通过循环优化设置不同的激励程度，结合患者就医行为效用分析，得到患者选择不同医疗机构的均衡决策，即不同医疗机构患者流到达的分布情况。为量化评估该患者流分布对于政策实施及整个医疗系统的影响效果，进一步建立带堵塞和批处理的马尔科夫模型，模拟当前医疗系统就诊号数量有限的现实情况，模型求解获得不同医疗机构就诊的等待时间和各类医疗机构的服务率，以此来说明激励政策所带来的量化效果。本研究将提出一套考虑患者决策、政府激励政策实施效果和医疗服务机构运作方式三者动态过程及其相互影响的多因素、循环优化决策的分析工具，以期为政府提供量化的决策支持方法，研究成果将有助于我国医疗改革解决"看病难"问题。

中文关键词： 博弈论；仿真优化；患者流；不完全信息；分层系统

英文摘要： Although national health condition of China has improved greatly along with the growing GDP, "inaccessibility" is still criticized as a major problem of the healthcare delivery system in China. The patient flow distribution currently in China is irrational. In this proposal, we take healthcare service quality, price and the waiting time as the main factors that will affect the patients' decision on choose the healthcare facilities. Also these factors will be considered as incentive to improve the patient flow distribution among different level's healthcare facilities. By dynamically and recurrently assign different level incentive, along with the analysis of patients' behavior, we will construct different utility function to different patients, and finally get the Bayesian Nash equilibrium of patients' decision under incomplete information. In order to model the patient congestion and limited healthcare resource, we propose to establish Markov model with blocking and batch service size. The blocking probability in general hospitals, the waiting time of patients to get healthcare service and the utilization of healthcare facilities can be obtained from the model. The advantage of this project is that we propose a novel optimization tool to improve the patient flow in China, which takes the patients decision makin

英文关键词： game theory；simulation optimization；patient flow；incomplete information；hierarchical system