考虑患者行为的门诊预约调度方法研究
Outpatient appointment scheduling method considering patient behavior
Abstract
Doctor resources generally exist the phenomenon of imbalance in diagnosis and treatment
load, the implementation of appointment diagnosis and treatment system can effectively
enhance the doctor reception plan and improve the utilization rate of resources. In the outpatient
appointmentschedulingsystem, thereservationsourceconfigurationrules affectthe
appointment experience and waiting time of patients, and the behaviors of patients' breaking
appointments and unpunctual arrival, the real-time entry behavior of non-reservation patients
disturbs the reservation and service plan made by the hospital in varying degrees, and the
hospital needs to make scheduling decisions according to the reservation and arrival of patients.
The traditional appointment scheduling method lacks the analysis of patients' behavior, so it is
easy to cause uneven leisure of doctors and long waiting time when directly applied to hospital
outpatient operation.
Aiming at the outpatient appointment scheduling problem considering patients' behavior,
this thesis aims to coordinate the supply of medical resources with the needs of patients,
improve the balance of doctors' resource load, and shorten the waiting time of patients. From
the three aspects of reservation scheduling process, reservation scheduling model construction
and solving method, this thesis proposes a reservation scheduling framework based on discrete
event simulation andgenetic algorithm. Itprovides an effective methodfor outpatient
appointment scheduling. The specific work is as follows:
(1) Analysis of outpatient appointment scheduling process based on patient behavior. First
of all, the types and characteristics of patients with different outpatient booking mechanisms
are analyzed, and a hybrid booking mechanism is proposed according to the advantages of
various mechanisms. Secondly, the behavior characteristics of patients are brought into the
scheduling process of outpatient appointment, and the business model of patient consultation
process is constructed. Finally, the basic concepts of queuing theory are introduced, the
characteristics of outpatient reservation scheduling are analyzed, and the priority-based queuing
rules for booking patients and real-time patients are proposed.
(2) Construction of outpatient appointment scheduling simulation model based on discrete
event simulation (DES). The outpatient reservation scheduling problem is divided into patient
reservation problem and patient scheduling problem, and the mathematical model of outpatient
reservation scheduling is constructed. On this basis, the DES-GA framework of outpatient
reservation scheduling is designed. The discrete event simulation method is used to model the
reservation scheduling scenario. Aiming at the patient reservation problem, the outpatient
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大连理工大学硕士学位论文
reservation number source configuration rules are designed by the combination of double
booking and vacancy strategy; aiming at the patient scheduling problem, three scheduling rules
are designed and the logical structure of each rule is analyzed. This provides a model basis for
solving reservation scheduling rules.
(3) Research on the solving method of outpatient appointment scheduling rules based on
genetic algorithm (GA). The coding mode of reservation scheduling rules and genetic operator
are designed, which are in line with the outpatient appointment scheduling scene. Through the
orthogonal test method, the simulation results are compared, and the influence of the main
parameters of the model is analyzed. The results show that with the increase of patients' non-
appointment rate, the time cost of the system increases; patients do not arrive on time will also
cause an increase in time cost, while the fluctuation level of doctor service time has little effect
on time cost.
This thesis not only enriches the theoretical research on the influence of patients' behavior
in outpatient appointment scheduling, expands the application scenario of genetic algorithm,
but also shortens the waiting time of patients, balances doctors' workload, and provides support
for hospital outpatient managers to adopt effective reservation scheduling strategy.
Key Words：Outpatient appointment scheduling; Discrete event simulation; Genetic
algorithm; Patient behavior
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考虑患者行为的门诊预约调度方法研究
目
录
摘
要....................I
Abstract .................... II
1绪论..................... 1
1.1研究背景与问题提出................. 1
1.1.1研究背景............ 1
1.1.2问题提出............ 2
1.2研究目的与意义.................. 3
1.2.1研究目的............ 3
1.2.2研究意义............ 3
1.3研究内容、方法与技术路线............ 4
1.3.1研究内容............ 4
1.3.2研究方法............ 5
1.3.3技术路线............ 6
1.4创新点.................... 7
2相关理论与研究综述.............. 9
2.1相关理论................ 9
2.1.1门诊预约调度理论.......... 9
2.1.2遗传算法................. 13
2.2国内外研究现状................ 15
2.2.1门诊预约调度中患者行为研究......... 15
2.2.2门诊预约调度研究方法.............. 16
2.3本章小结.............. 18
3门诊预约调度流程分析............... 20
3.1门诊预约机制............. 20
3.2患者行为特征............. 21
3.2.1预约患者爽约................ 21
3.2.2预约患者不准时到达........... 21
3.2.3实时患者步入................ 22
3.3患者就诊流程分析............ 23
3.3.1就诊流程概述................ 23
3.3.2预约调度排队系统............... 24
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