可变预约时段的柔性预约机制仿真

Simulation on flexible appointment mechanism with varied appointment time slot

目的针对预约就诊中的不确定性,从可变分时段预约视角研究分析柔性预约方法以提高医护资源效率。方法提出一种新的柔性交错预约时段策略,通过Simio仿真平台构建考虑负荷、医生服务时间偏差及失约等不确定性的柔性预约时段模型,仿真分析在不同情境下可变交错时段对系统成本、患者等待时间、医生加班时间和空闲时间等指标的变化规律。结果分时段预约策略较步入式能降低患者平均等待时间48.85%;在高负荷与正常负荷情境,采取适当正向交错率预约时段策略能改进预约系统评价指标,尤其在高负荷、高服务时间偏差下正向交错率预约时段策略效果最佳。在不同失约率下,最优交错率预约时段策略随着失约率增加由正向交错率变为负向交错率策略。结论仿真结果可为分时段预约调度提供参考,在不同情境下给出相应柔性交错率策略推荐,为医院决策提供量化基础。

Objective In order to improve the efficiency of medical resources,this paper analyzes a variable flexible appointment time method from the perspective of time appointments.Methods A new flexible overlapping appointment time slot strategy is proposed.Then we use the simio simulation platform to build a flexible appointment period simulation model of different load rates,service time deviations and patients’no-show rates.The changing rules on the overlapping rate to the system cost,patient waiting time,doctor overtime and free time.Results The numerical experiments show that the time-division strategy can reduce the average waiting time of patients by 48.85%compared with the walk-in strategy.Under high-load and normal-load,adopting the positive overlapping rate appointment strategy can improve appointment system evaluation index.Especially under high load and high service time deviation,the positive overlapping rate appointment strategy works best.Comparing the different no-show rates,the optimal overlapping rate appointment strategy gradually shifts from positive to negative strategies as the no-show rate increases.Conclusions The best flexible appointment strategy recommendation is given to provide a quantitative basis in different situation for hospital decision-making.