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中文摘要：
通过分析门诊业务流程特征,构建了基于排队论的I2型路由策略的门诊多阶段排队系统数学分析模型.描述了病人在门诊中挂号、诊断、检查、复诊、缴费、取药的全流程,给出了病人等待时间、护士空闲概率等系统性能指标的定量表达式.在此基础上,建立了以病人等待时间成本和护士空闲时间成本为目标的医疗单元能力优化配置模型.通过对模型特征的分析,设计了启发式的邻域搜索模拟退火算法,进一步通过枚举法求得了系统护士数量最优需求.通过数值实验分析了病人到达率对护士分配方案的影响,发现了在不同病人流到达情况下系统存在的瓶颈环节;分析了病人等待时间与护士空闲时间的成本比值对护士配置数量的影响.研究结果对护士资源优化配置与管理的实际工作具有一定的指导作用.
英文摘要：
A general multistage queueing network model with I2 patient routing is established to formulate the behavior of patient flow in an outpatient department（ OD） in a hospital,proceeding from registration to diagnosis,chemical examination,referral,payment,and medicine-taking.The formula of performance indicators such as patient waiting time and probability of nurses being idle are derived from system parameters.Focusing on nurse staffing and allocation,a mathematical programming model is developed to determine how many nurses are needed and how to allocate nurses to each stage /division to minimize the total costs of patient waiting time and nurse idle time.A neighborhood search combined simulated annealing（ NS-SA） with heuristic is developed.Optimal nurse numbers are derived from the enumeration method based on NS-SA.Numerical experiments are conducted to analyze the impact of patient arrival on the allocation of nurses and the ratio of patient waiting time and nurse idle time on the number of nurses needed.The bottleneck in the system is found.The research results can facilitate human resource decision making by hospital managers.
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