面向时变需求的多等级急诊患者入院控制

doi:10.16183/j.cnki.jsjtu.2021.122

上海交通大学学报 ›› 2022, Vol. 56 ›› Issue (8): 1067-1077.doi: 10.16183/j.cnki.jsjtu.2021.122

面向时变需求的多等级急诊患者入院控制

徐捷¹, 王子翔¹, 刘玉欣¹, 刘冉¹, 杨之涛²()

1.上海交通大学机械与动力工程学院,上海 200240
2.上海交通大学医学院附属瑞金医院急诊科,上海 200025

收稿日期:2021-06-17 出版日期:2022-08-28 发布日期:2022-08-26
通讯作者: 杨之涛 E-mail:yangzhitao@hotmail.fr
作者简介:徐捷(1997-),男,安徽省池州市人,硕士生,研究方向为医疗服务管理和随机系统建模优化.
基金资助:
国家社会科学基金资助项目(19BGL245)

Admission Control of Multi-Level Emergency Patients with Time-Varying Demands

XU Jie¹, WANG Zixiang¹, LIU Yuxin¹, LIU Ran¹, YANG Zhitao²()

1. School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
2. Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received:2021-06-17 Online:2022-08-28 Published:2022-08-26
Contact: YANG Zhitao E-mail:yangzhitao@hotmail.fr

摘要/Abstract

摘要：

建立患者准入控制的Markov决策过程(MDP)模型,并基于均匀化方法对该模型进行拓展,实现逐时段的实时决策过程.拓展经典MDP迭代求解方法,提出双向迭代算法、逐时段策略迭代算法等方法对模型求解.以上海某大型医院抢救室为例,数值实验表明:对比现有决策方法,所提出的新方法可以提高危重患者的接收率,提升急诊医疗的服务水平.

关键词: 患者入院控制, Markov决策过程, 均匀化方法, 时变需求

Abstract:

The Markov decision process (MDP) model is developed for the patient admission control problem and is extended based on the uniformization method to realize a real-time period-by-period decision process. The classical MDP iterative method is extended, and the two-way iteration algorithm and the two-way threshold iteration algorithm are proposed to solve the new model. Numerical experiments are conducted based on the data from the resuscitation room of a large hospital in Shanghai. The results show that the proposed method can improve the admission rate of critical patients and enhance the medical service level of the hospital compared with the existing decision method.

Key words: patient admission control, Markov decision process(MDP), uniformization method, time-varying demands

中图分类号:

TP13
R197.32

徐捷, 王子翔, 刘玉欣, 刘冉, 杨之涛. 面向时变需求的多等级急诊患者入院控制[J]. 上海交通大学学报, 2022, 56(8): 1067-1077.

XU Jie, WANG Zixiang, LIU Yuxin, LIU Ran, YANG Zhitao. Admission Control of Multi-Level Emergency Patients with Time-Varying Demands[J]. Journal of Shanghai Jiao Tong University, 2022, 56(8): 1067-1077.

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参考文献 18

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参数	取值
N	3
T	6
Δ	1
μ⁰, μ¹	0.4, 0.63

算例	双向迭代算法总收益	枚举总收益
1	58.565	58.565
2	30.453	30.453
3	134.397	134.397
4	106.729	106.729
5	64.915	64.915
6	35.923	35.923
7	143.311	143.311
8	114.536	114.536

参数	取值
N	30
T	24
Δ	1
μ⁰, μ¹	0.1, 0.333
r⁰, r¹	20, 3
p⁰, p¹	-30,-1

策略	均匀化评估总收益	仿真评估总收益	收益提升/%	算法运行时间/s
K0	1023.18	1023.38	-	-
K1	1094.26	1094.58	6.96	15481
K2	1093.97	1094.14	6.91	706
K3	1057.48	1057.16	3.30	691

K0				K1				K2				K3
Y	Y₀	Y₁		Y	Y₀	Y₁		Y	Y₀	Y₁		Y	Y₀	Y₁
0.956	0.956	0.956		0.912	0.991	0.842		0.913	0.991	0.845		0.886	0.981	0.798

面向时变需求的多等级急诊患者入院控制

Admission Control of Multi-Level Emergency Patients with Time-Varying Demands

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参考文献 18

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Metrics

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N	均匀化评估总收益	相比N-1的增长率/%
25	980.51	-
26	1010.43	3.05
27	1036.23	2.55
28	1058.45	2.14
29	1077.68	1.82
30	1093.97	1.51
31	1107.60	1.25
32	1118.95	1.02
33	1128.31	0.84
34	1135.90	0.67
35	1142.01	0.54

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