摘要
【目的】通过建模讨论医疗中影响分诊的一个重要因素,即患者在专家门诊预约时行为决策的影响因素和模式,为医院的专家门诊及分诊管理提供建议。【方法】首先对患者在专家门诊预约挂号时的排队行为模式进行分析,考虑专家服务质量、患者焦虑程度、患者对专家的期望值以及排队成本等因素建立了患者选择某一专家的服务价值模型,根据该价值模型可以推算患者的最长容忍等待时间和最长容忍排队队长。另一方面,将一个专家看作是一个服务台,则一个专家的排队系统是M/M/1/K类型的,K为该专家一日看诊量。分别分析K值固定时最优服务率、K值变动时最优服务率及对应的最优K取值。结合患者行为决策模型和专家排队系统模型提出医院的应对策略,最后对医院专家门诊及分诊的管理提出建议。【结果】建立了基于专家服务质量、排队成本和患者焦虑程度的患者排队行为决策模型,以此确定患者的最长容忍等待时间和最长容忍排队队长,建立了专家排队系统模型,并将行为决策模型与排队系统模型结合,提出医院应对策略。针对以上模型结合实际应用分别设计算例,算例证明方法的可行性。【结论】该研究一方面从患者排队行为角度建立了决策模型,该模型对已有的质量的模型进行修改,加入了口碑因子;又对行为决策影响因素,在质量和成本因素之外加入了焦虑程度因素。另一方面,从医院角度综合考虑患者满意度和医院效益分析专家看诊最优服务率的确定。最后给出了具体管理建议。但从行为决策角度看,患者在选择专家或医院时有许多不确定因素,该研究只是分析了其中一部分,有待深入探索。
[Purposes]Nowadays,patients blindly pursue "the best"when choosing medical resources,leading to the difficulty to make appointment to famous specialist in large hospitals.Medical institutions want to solve such problems by triage.One of the important factors in the triage is what factors and patterns are the main factors and patterns of the patient’s decision making in a specialist outpatient appointment.[Methods]Firstly,the queuing behavior model of patients in the specialist outpatient appointment registration is analyzed.Considering the factors of specialist service quality,patient anxiety,expectancies of patients to specialists and queuing cost,the service value model of patients choosing a certain specialist is established.According to the model,the patient’s longest tolerating waiting time and longest tolerating queue length can be calculated.On the other hand,take the specialist as a service desk,then a specialist’s queuing system is a M/M/1/K system,and K is the specialist’s daily visits.The optimal service rate at fixed K value,optimal service rate and corresponding optimal K value when K value changes is analyzed respectively.Combining patient behavior decision-making model and specialist queuing system model,the hospital’s coping strategies are puts forward,and finally the management suggestions of hospital specialist outpatient service and consultation are proposed.[Findings]A queuing behavior decision-making model based on specialist service quality,queuing cost and patient anxiety was established to determine the longest tolerant waiting time and queuing queue length of patients.The specialist queuing system model was established,and the behavior decision-making model was combined with the queuing system model to propose hospital response strategies.An example is given to illustrate the feasibility of the method.Finally,feasible suggestions for specialist outpatient management are put forward.[Conclusions]On the one hand,the study establishes a decision-making model from the perspective of
作者
羊英
李静
YANG Ying;LI Jing(School of Economics and Management,Shanghai Polytechnic University,Shanghai 201209;Shanghai General Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai 200080,China)
出处
《重庆师范大学学报（自然科学版）》
CAS
北大核心
2019年第1期21-28,共8页
Journal of Chongqing Normal University:Natural Science
基金
上海市科学技术委员会项目(No.17495810503)
关键词
行为决策
决策建模
专家门诊预约
排队行为
behavioral decision
decision modeling
specialist outpatient appointment
queuing behavior
