Healthcare Alliance Referral Decision Optimization Based On Threshold Control Policy

At this stage,the world is facing two major challenges in the field of medical services.First,the shortage of medical resources,rising costs,and secondly,the utilization rate of medical resources in different regions and different levels of medical institutions is seriously unbalanced.China's healthcare system has been plagued by these two problems for a long time as well.In order to cope with these two problems,our government put forward the concept of "medical association" and vigorously promoted it.However,there are still a series of problems in the actual operation process of the policy of the Medical Consortium.Aiming at the two types of the Medical Consortium,this paper puts forward the optimization measures at the operational level.Aiming at the problem of tight Medical Association in operation level,this paper proposes a threshold control strategy based on the number of hospital bed resources.Queuing model of a tight medical association system consisting of a upper-level hospital and a lower-level hospital is established.The steady-state probability of the Markov chain is solved by RG decomposition algorithm,and the system of patient output rate and blocking rate are defined.An optimization problem with control threshold K as decision variable is constructed.By simplifying the model,the analytical results of system steady-state probability and system evaluation index are deduced,and then the system characteristics are discussed theoretically.On this basis,a heuristic optimization algorithm is proposed.Aiming at the operational problems of loose medical consortium,this paper proposes a process-oriented cooperation framework,which doesn't contain result-oriented parameters,but process-oriented control parameters.Firstly,a queuing model with low fidelity is constructed,which assumes exponential distribution for both arrival rate and service rate.Secondly,a simulation model with high fidelity is constructed.The arrival rate and service rate of the simulation model are generally distributed.Finally,based on the improved OTOS optimization algorithm,the low fidelity queuing model and the high-fidelity simulation model are combined,without damaging the results,on the premise of accuracy,the efficiency of solution is improved.Finally,through field research,this paper collects the real data of two types of medical consortia in Shanghai,and carries out case analysis based on these data,and obtains effective conclusions which have enlightening significance for medical management practice.