基于门诊病人流量优化医院床位数量:理论模型及政策含义

Optimizing bed capacity based on outpatient flow in hospitals:The model and policy implications

从理论假设出发,本文认为基于门(急)诊病人流量的多少,可以推算出住院病人数量,再根据住院病人的平均住院天数,可以估算出医院需要的最优床位数量。通过分析、论证及检验,表明这是我国医院设置病床普遍采用的一种方法。所以,我国公立医院床位扩张的直接原因,是由于医院病人流量过多。解决大型公立医院规模过大问题,相关管理部门应从根本上进行合理的区域卫生规划,加强多元化办医,促使医疗资源的合理分配及利用。否则,直接的、盲目的控制医院的床位规模,并不能使医疗资源得到合理配置,而且会加重患者看病难的问题。

Taking the basic assumption that emergency-and-in-patient flow is a Poisson Process, we deem that the optimum bed capacity in hospitals can be estimated by the size of emergency-and-in-patient flow, the number of inpatients and average staying days in hospital. Through the process of analyzing, proving and testing, we show that the method is generally adopted by hospitals to design their bed capacity. Hence, the proximate reason to explain why public hospitals expanding bed capacity is that the size of patient flow is too much. In attempt to solve the problem of large public hospitals’ over-size scale, health authorities are primarily supposed to commit health regional planning program, to promote diversified hospitals ownership and to render medical resources reasonably allocated and consumed. Otherwise, direct and arbitrary controlling bed capacity contributes to fail to facilitate reasonable allocation of medical resources, and to aggravate the problem of difficult-to-approach-treatment-for-patients.