運用啟發式演算法求解病患轉檢機制之模擬

Applying simulation and metaheuristics to solve patient referral issue

林明翰(Ming-Han Lin)

指導教授 ： 陳平舜

中原大學/電機資訊學院/工業與系統工程研究所/碩士(2014年)

https://doi.org/10.6840/cycu201400443

摘要

醫療資源關係到醫院的服務品質，無法有效的利用醫療資源即表示無法滿足病患之期望和要求，更會造成醫療資源的浪費。因此，醫院如何有效的分配醫療資源為一重要議題。民眾普遍認為大醫院的醫療資源充足，醫護人員之技術較小醫院好，所以病患紛紛投向大醫院，導致大醫院病患數過多無法負荷，病患必須等很長的一段時間才能接受檢查診療，病患等待時間過長會造成錯失醫療的黃金時段，影響醫院的醫療品質。小醫院則因為病患數量少，醫療資源利用率低，造成醫療資源的浪費。
本研究的目的為探討多間醫院之間的轉檢機制，考量因醫院大小而會有病患數量不同，如何有效轉檢病患到其他間醫院。若能有效地轉檢病患到需要的醫院，將可縮短病患的等待時間，進而提升醫院的醫療品質。
本研究利用系統模擬概念及結合啟發式演算法，發展多間醫院之間的三種轉檢機制，以求出較佳的轉檢人數。本研究根據研究情境及結果，分析三種的轉檢機制，以探討其可行性和效果。

關鍵字

啟發式演算法 ； 預約安排 ； 病患轉檢機制 ； 系統模擬

並列摘要

Medical resources have impacts on service quality of hospitals. Using the medical resources ineffectively leads to fail to meet patients’ expectations and demands. This will cause to the idleness of medical resources. Therefore, how to allocate medical resources effectively becomes an important topic. In general, people believe that large hospitals have abundant medical resources and their medical staff are better than those of small hospitals. It results that patients go to large hospitals more often. Consequently, patients have to wait longer time to have their treatment in large hospitals. However, since the long waiting time will fail to treat patients timely, it will reduce the quality of healthcare of hospitals. On the contrary, due to small quantities of patients, the medical resource utilization of small hospitals is low, resulting in the idleness of medical resources.
The goal of this study is to investigate referring mechanisms among hospitals, which have different scales and the number of patients. The question is how to transfer excess patients effectively to other referring hospitals. If hospitals can transfer patients to the referring hospital effectively, the patient’s waiting time will be shorten. It will improve the quality of healthcare. In order to determine the better number of referring patients among hospitals, this research uses system simulation with heuristic algorithms to develop three referring mechanisms among hospitals. According to the research scenarios and results, this study analyzes the feasibility and effectiveness of three referring mechanisms.

並列關鍵字

Metaheuristics ； Simulation ； Patient referring mechanism ； Scheduling appointment

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