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Differential equations modeling of patients and physicians dynamics in emergency rooms: Optimal control policies and heuristic implementation methods.

机译:急诊室中患者和医生动态的微分方程建模:最佳控制策略和启发式实施方法。

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摘要

Hospital emergency rooms are difficult to manage because of the complexity of allocating costly clinical resources, mainly physicians, in light of uncertainty in the arrivals of patients, the increasingly crowded emergency rooms, and the costs of delaying medical treatment. Without effective clinical resource management, emergency rooms are less prepared to deal with unanticipated surge in service demand and are also less able to reduce crowding of patients. Crowding of patients is a particular concern at the national level because when emergency rooms are crowded, medical care is delayed and the likelihood of poor quality care is high. We propose a model using ordinary differential equations to evaluate the natural dynamics of patients and physicians in emergency rooms. From understanding the natural dynamics, we use optimal control theory to determine the optimal dynamics of physicians to increase the benefits of treating more patients while controlling the costs of medical care. Numerical simulations of our model, using actual hospital data, suggest a continuous physicians' optimal control policy. To implement such continuous policy in a practical way, we use discretization methods based on the concepts of the least square methods and the mean value theorem for integration applied to the previously determined optimal control policy.
机译:鉴于患者的到来情况不确定,急诊室越来越拥挤以及延误治疗的成本,由于分配昂贵的临床资源(主要是医生)的复杂性,医院急诊室难以管理。没有有效的临床资源管理,急诊室准备不足以应对意料之外的服务需求激增,也无法减少患者拥挤。在国家一级,患者的拥挤是一个特别令人关注的问题,因为当急诊室拥挤时,医疗服务就会延迟,护理质量差的可能性很高。我们提出了一个使用常微分方程的模型来评估急诊室中患者和医生的自然动态。通过了解自然动力学,我们使用最佳控制理论来确定医生的最佳动力学,以增加治疗更多患者的利益,同时控制医疗费用。使用实际医院数据对我们的模型进行数值模拟,表明了连续的医师最佳控制策略。为了以一种实用的方式实施这种连续策略,我们使用了基于最小二乘法的概念和适用于先前确定的最优控制策略的积分均值定理的离散化方法。

著录项

  • 作者

    Ndayishimiye, Jerome.;

  • 作者单位

    State University of New York at Buffalo.;

  • 授予单位 State University of New York at Buffalo.;
  • 学科 Engineering Industrial.;Operations Research.;Health Sciences Health Care Management.
  • 学位 M.S.
  • 年度 2011
  • 页码 50 p.
  • 总页数 50
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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