基于网络规划的社区卫生服务可及性

Accessibility and equality of community healthcare service network planning

为提高中国医疗服务的可及性,满足居民的需求,建立了线性混合整数规划模型,研究在预算、就诊距离等约束条件下,确定社区卫生服务网络的最优选址、服务能力以及服务种类。以北京市海淀区为例进行模型验证,通过与当前社区卫生服务网络对比,模型的优化结果使区域内年服务数量、人均就医成本等指标均优化了20%以上。模型参数灵敏度分析的结果可为政府在不同预算、居民转诊条件下规划社区卫生服务系统提供决策支持。

A mixed integer mathematical model was developed to establish a well planned community healthcare network to improve accessibility in the China＇s community health care network. The model constrains the budget and travel distance while maximizing the total number of patients served. The capacity and service type in each community health center are also determined. The optimized model improves the access to community health care by over 20% while reducing the expense per patient by over 20~ compared with the original community health care network for the Haidian District, Beijing as on example. A sensitivity analysis is used to give suggestions on changes to make when budget and patient travel distance situations change.