两种医疗系统拥塞解决机制的比较

项目名称： 两种医疗系统拥塞解决机制的比较

项目编号： No.71302078

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： 钱驱

作者单位： 上海财经大学

项目金额： 23万元

中文摘要： 中国医疗改革的一个难点问题是如何改变医疗服务需求高度集中于高等级医疗机构的现状。服务需求分布不均衡造成系统拥塞的现象也普遍存在于世界各国的医疗系统中。如何对病人进行合理引导，使得服务需求在各种医疗机构间均衡分布，从而有效地利用有限的医疗资源成为各国医改的一个重点。本课题将从病人等待时间、运营效率和社会福利的角度比较两种广泛应用于医疗系统以解决系统拥塞，平衡医疗需求的机制：价格补贴机制和有限等待机制。本课题将在现有的医疗服务运营理论框架的基础上构建病人在每种机制下的排队模型，模型的构建考虑到不同的服务延迟信息对于病人决策的影响。医疗系统被模拟成有多个服务器的排队系统，通过马尔可夫过程和平面交叉法推导出系统的均衡状态，分析不同情况下每种机制的最优参数选择；通过对均衡状态下系统各项指标的分析和测算，比较两种机制在不同情况下解决系统拥塞的有效性；理论结果结合案例分析对中国医改实践提供建议。

中文关键词： 医疗服务运营管理；系统拥塞；排队论；价格补贴；有限等待

英文摘要： One of the critical issues in China's health care reform is that the demand for health care highly concentrates on high level health organizations. The imbalance of health care demand among different types of health service organizations is also a common phenomenon in other countries. This project aims to discuss and compare two mechanisms that are widely used to relieve congestion in the health system and balance health demand distribution: price subsidization mechanism and limited waiting mechanism. The comparison is conducted from the perspectives of patient waiting time, operations efficiency and social welfare. Based on the existing theoretical framework of healthcare operations studies, this project will construct patient queueing models under different mechanisms and different forms of delay information. Markove process and level crossing method will be used to derive the system equilibria and the optimization of parameter under different conditions. By comparing the system performance under different conditions, this project will assess the relative effeciency of the two mechanisms. Together with the results of case study, this project will provide suggestions to China's healthcare reform.

英文关键词： Health Service Operations Management；System Congestion；Queueing Theory；Price Subsidization；Limited Waiting