不同付费方式下医联体患者床位安排优化研究

Optimization of Bed Arrangement in Medical Consortium under Different Payment Methods

目的构建不同付费方式下医联体患者病床安排优化模型,提高医院服务效率。方法基于医联体背景,将患者分为急诊患者、转诊择期患者、普通择期患者,构建不同付费方式下以收益最大化为目标的医联体患者病床安排优化模型,并基于延安市医联体内某三甲医院实际数据进行案例求解与分析。结果采用按项目付费时,使用整数规划模型能够使医院收益提高189.9%;采用按DRGs付费时,使用整数规划模型能够使医院收益提高61.9%。结论不同付费方式下医联体患者病床安排整数规划模型在一定程度上提高了医疗资源使用效率,对DRGs政策实施后的患者病床安排问题具有一定现实意义。

Objective To construct an optimization model for hospital bed arrangements for medical consortium patients under different payment methods to improve hospital service efficiency.Methods Based on the medical consortium background,patients were divided into emergency patients,referral elective patients,and ordinary elective patients,and constructed an optimization model of hospital bed arrangement for medical consortium patients in the context of different payment methods with the goal of revenue maximization.Case-solving and analysis of actual data from a tertiary hospital in medical consortium in Yan'an was done.Results When the hospital adopted the fee-for-service,the integer programming models could improve hospital benefits by 189.9%.Using the integer programming model to pay for DRGs,the hospital benefits increased by 61.9%.Conclusion The constructed optimization model of hospital bed arrangement for medical consortium patients under different payment methods had improved the efficiency of medical resource utilization to a certain extent,and has certain practical significance for the patient bed arrangement problem after the implementation of the DRGs policy.