考虑区域疫情风险不确定性的公共卫生应急医疗机构选址研究

Research on Emergency Medical Institution Location for Public Health Emergencies Considering Regional Epidemic Risk

突发公共卫生事件情境下,提供紧急医疗救治服务的应急医疗机构在疫情防控中发挥着重要作用。本文考虑疫情的区域间和区域内传播特性,提出了一个考虑区域疫情风险不确定性的、有最大距离约束的p-中值模型,并为模型设计了一种改进的贪婪取走启发式算法。同时,将模型应用于新冠疫情背景下安徽省定点医院的选址问题,提出了不同疫情形势和决策者风险态度下的三组设施点选址策略和一个三层级的设施点调整策略,并在传染病医院远离居民区原则下,给出了一个定点医院的选址策略。最后,本文从坚持底线思维,适度超前布局规划;重点关注高风险地区,合理布局;分类施策、分级应对,根据形势确定选址策略;“平战结合”,重视医疗设施的“平”“战”转换能力等方面,为做好医疗救治资源的合理设置提出政策建议。

In the context of public health emergencies,emergency medical institutions providing emergency medical services play an important role in epidemic prevention and control.In this paper,we considered the transmission characteristics of epidemic within and between regions,proposed a location model of public health emergency medical institutions based on improved p-median model considering the uncertainty of regional epidemic risk,and an improved greedy removal algorithm to solve the model,and applied the model to the location of COVID 19 designated hospitals in Anhui.In view of different external epidemic environment and decisionmakers risk attitude,three groups of facility location strategies and a three-level facility adjustment strategy are proposed.Under the principle that infectious disease hospitals should be far away from residential areas,designated hospitals are selected among candidate hospitals at the facility sites,and a compromise strategy for designated hospital location was proposed.Finally,this paper put forward policy suggestions for the rational setting of medical treatment resources,i.e.insisting on the bottom line thinking and moderately advanced layout planning;focus on high-risk areas,rational layout;classified policy,graded response,and site selection strategy according to the situation;combining peacetime with wartime,paying attention to the ability of medical facilities to change from peacetime to wartime.