稀缺醫療服務資源之 逐日預約排程問題研究

Abstract

本研究為稀缺醫療服務資源之逐日預約排程問題，稀缺醫療服務由於醫療設備昂貴，且醫院人力資源有限，因此這類型服務每個時段只能提供固定數量的服務名額供病患預約就診。病患根據看診需要對於預約時間有不同的需求，而病患對於就診時段也有不同的偏好，預約系統根據預約排程規則安排病患預約就診 本研究提出兩種預約排程規則IFB(Improved FCFSBU)以及IFBP(Improved FCFSBU with Patient Preference)。IFB混和先到先服務與平衡負載兩種政策，並根據預約系統內剩餘名額動態調整兩種政策權重，當病患進入預約系統時，預約系統計算各時段的FCFSBU分數並挑選最適的時段給病患預約就診。另外，IFBP在原有先到先服務與平衡負載兩種概念外增加考量病患時段偏好，使預約系統在滿足病患預約需求時，同時兼顧病患時段偏好。 本研究根據醫院實際歷史資料模擬病患進入預約系統情形，比較本研究所提之預約排程規則與醫院現有預約排程規則。結果顯示IFB與醫院現有預約排程規則相比可滿足更多病患的預約需求，而IFBP可讓預約系統在大部分病患都能滿足預約需求的前提下，讓多數的病患能在其偏好的時段預約就診。

This study considers an appointment scheduling problem for medical services with limited resources. In this type of medical service, the medical resource or equipment can only offer a limited number of services for patients each day and its capacity is costly to expand. In addition, patients have different required ranges of time to access the service based on their diagnostic urgencies and they may have their own preferred appointment timeslots. Based on an appointment rule, the appointment system assigns a timeslot to each patient. In this research, we propose two appointment scheduling rules: IFB (Improved FCFSBU) and IFBP (Improved FCFSBU with Patient Preference). IFB combines two appointment policies: “First Come First Serve (FCFS)” and “Balance Utilization (BU)”. When a patient accesses the appointment system, the system will calculate a score for every timeslot within his/her required ranges of time based on FCFS and BU and assign the best timeslot to the patient. Moreover, according to the system’s status, the appointment system will dynamically adjust the weights of these two policies when calculating scores. Furthermore, IFBP considers a patient’s preference for services timeslots. IFBP attempts to make the patients receive the medical service not only within their required ranges of time but also in their preferred timeslots. In order to evaluate the performance of the proposed appointment rules, a simulation is conducted. We use a practical case as the simulation model and compare the proposed rules with others. The result shows that a higher proportion of patients can receive the medical service in their required timespan when using IFB. In addition, patients have more chances to make appointments in their preferred timeslots when adopting IFBP.