| 有限资源下医联体服务能力优化与分诊策略研究 |
| Research on optimization of service capability and triage strategy of medical consortia under limited resources |
| 摘要点击 21 全文点击 0 投稿时间：2024-07-26 修订日期：2025-05-07 |
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| 中文关键词 分级诊疗；医联体；排队模型；服务能力 |
| 英文关键词 tiered medical; medical consortium; queueing model; service capacity. |
| 基金项目 北京市社会科学基金项目(22GLC068) |
| 作者 | 单位 | 邮编 | | 张钰 | 北京科技大学 | 100083 | | 杨晓东 | 北京科技大学 | | | 闫相斌 | 广东外语外贸大学商学院/北京科技大学/ | | | 王金亭* | 中央财经大学 | 102206 |
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| 中文摘要 |
| 针对我国医疗资源紧缺的现状, 本文聚焦于医联体资源优化配置与患者分诊问题. 通过构建基于排队论的医联体分诊模型, 依据患者病情的严重程度, 将患者分诊至各级医疗机构, 本文分析了医联体成本最小化以及患者效用最大化的服务能力分配策略与分诊机制设计. 面对医联体运营成本与患者满意之间的矛盾, 提出了政府补贴以降低资源成本或优化资源分配的解决方案. 研究表明, 在医联体自主调控医疗资源与分诊策略时, ``社区首诊, 按需转诊" 模式可有效降低成本. 然而, 当政府和医联体之间存在博弈关系, 政府主导医疗资源宏观调配而医联体调整分诊策略时, ``资源集中于三甲医院" 策略是双方博弈的稳定均衡点. 分级诊疗机制的适用性受到患者规模的影响. 在患者规模适中的情况下, 分级诊疗能够较好地平衡医联体与患者之间的需求, 实现双方的共同满意. 数值实验结果证明, 增加医疗资源供给与减少社区医院的竞争对于优化医联体成本结构、提升患者服务体验具有显著的积极作用. 相关研究结论可以为医疗政策制定提供了坚实的理论支撑与策略参考, 有助于推动我国医联体的建设与发展. |
| 英文摘要 |
| In view of the shortage of general practitioners and limited medical equipments in China, this paper examines the limited resource allocation within medical consortia, as well as the referral strategies of patients.By constructing a medical consortium triage model based on queueing theory and triaging patients to medical institutions at different levels according to the severity of their conditions, this paper analyzes the service capacity allocation strategies and triage mechanism design that minimize medical consortium costs or maximize patient utility. Facing the contradiction between the operating costs of medical consortiums and patient satisfaction, solutions are proposed to reduce resource costs through government subsidies or optimize resource allocation. The study shows that when medical consortiums independently regulate medical resources and triage strategies, the ``community-first and referral-on-demand" model can effectively reduce costs. However, when there is a game relationship between the government and medical consortiums, with the government allocating medical resources and medical consortiums adjusting triage strategies, the ``resource concentration in tertiary hospitals" strategy becomes a stable equilibrium point. The applicability of the hierarchical diagnosis and treatment mechanism is affected by the patient scale. In the case of a moderate patient scale, hierarchical diagnosis and treatment can better balance the needs of medical consortiums and patients, achieving mutual satisfaction. Numerical experimental results prove that increasing the supply of medical resources and reducing competition among community hospitals have significant positive effects on optimizing the cost of medical consortiums and enhancing patient service experience. Relevant research conclusions can provide solid theoretical support and strategic references for the formulation of medical policies, and promote the construction and development of medical consortia in China. |
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