Research On OptimalAllocationof Medical Resources And Two-way ReferralforMedicalAssociation

Since the reform and opening up,China has made remarkable achievements in economic construction and social development.With China’s booming economy,the contradiction between the ever-increasing medical services needs and unbalanced development is increasingly prominent.The state and local governments at various levels are actively promoting the construction of medical association with the goal of optimizing resources allocation and cooperation with multi-level medical institutions.This is an important approach to establish a hierarchical diagnosis and treatment systme and realize the accessibility and efficiency of medical services.The balanced distribution of medical resources and the effectiveness of two-way referral provide important theoretical and practical values for improving the basic-level medical services,promoting the overall efficiency of medical services,and achieving the sustainable development of medical association.Based on the analysis of the research status at home and abroad and the integrated practice of medical resources,the optimal allocation of medical resources and two-way referral decisions for the medical association was systematically studied from the perspective of resource integration and innovation in this study.The key issue,such as the evaluation of the overall development capability of the medical association,was explored in depth.A data envelopment analysis was proposed to build a medical resource allocation model in the same-level hospital for the medical association.It solved the indicator redundancy problem in the study of medical resource allocation.A two-way referral decision pattern was designed based on stochastic multicriteria acceptability analysis.The uncertainty in both attribute values and weights of referral satisfaction evaluation were solved.We proposed an evaluation method for the development ability of the medical association based on the prospect theory to solve the problems of different evaluation criterions and the lack of scientific evaluation method in the medical association construction.The method broke the limitation in the process of assessment framework transformation using the traditional evidential reasoning.The specific research contents and innovation in this study were as follows:(1)A medical resource allocation method for the medical association based on DEA model of indicators reduction was proposed.On the basis of domestic and foreign research and combined with the characteristics of medical resource allocation problems,the input and output indicators were selected as human,finance,materials,etc.Input and output indicators were reducted for dimensionality respectively by the factor analysis to solve the indicator redundancy problem.The common factors were obtained by fitting,such as such as patient costs and medical satisfaction.Finally,combined with BCC and CCR model of the data envelopment analysis,we analyzed the efficiency of medical resource allocation for some member units of the children’s medical association in Anhui Province and proposed the corresponding adjustment strategy.(2)A two-way referral decision method for the medical association was proposed in consideration with the uncertainty of weights and attribute values.According to thecharacteristics of the two-way referral in medical association,a two-way referral decision method based on two-sided matching model was established.The stochastic multicriteria acceptability analysis was performed for the improvement of the traditional two-sided matching model to solve the uncertainty of the attribute values and weights.Finally,the effectiveness and feasibility of the improved method in the two-way referral application was verified by the experiment.(3)An evaluation method for the development capability for the medical association based on the equivalent conversion of prospect values was proposed.By the analysis of the essential elements and the establishment principles in the evaluation indicator system for the medical association,based on the current domestic medical indicator systems,an evaluation indicator system was proposed with the characteristics of both qualitative and quantitative indicators,such as relatively comprehensive,structured and diverse properties.According to the prospect theory,an improved evidence reasoning was proposed and it was a comprehensive evaluation method of evidence reasoning based on prospect value transformation.Finally,the effectiveness and feasibility of the improved model for the evaluation of medical development capacity was verified by experiments.The effects of decision makers’risk attitudes on the assessment results were explored.The construction of medical association has become an important approach for the state and local governments in various levels to promote a hierarchical diagnosis and treatment system.The rationality of the medical resource allocation and the effectiveness of two-way referral decisions are directly related to the development capability of the medical association,which further affects the implement of the hierarchical diagnosis and treatment The sustainable development of the medical association is affected by medical resources allocation and referral preference difference between hospitals in different levels.In particular,the research on them are significant to improve the social benefits of the development for the medical association.It is necessary to carry out the relevant basic theoretical research.In addition,medical coordination tasks represented by multi-disciplinary consultation and remote teaching are promoted on a large scale.How to improve the development vitality of the medical association by the establishment of a standardized and highly effective inter-regional physician collaboration mechanism will be an important research direction in the future.