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使用离散事件模拟评估家庭医疗诊所的设计。

Evaluating the design of a family practice healthcare clinic using discrete-event simulation.

作者信息

Swisher James R, Jacobson Sheldon H

机构信息

Mary Washington Hospital, Fredericksburg, VA 22401, USA.

出版信息

Health Care Manag Sci. 2002 Apr;5(2):75-88. doi: 10.1023/a:1014464529565.

Abstract

With increased pressures from governmental and insurance agencies, today's physician devotes less time to patient care and more time to administration. To assist physician clinics in evaluating potential operating procedures that improve operating efficiencies and better satisfy patients, an object-oriented discrete-event simulation model has been constructed using the Visual Simulation Environment (VSE). The research presented herein describes a methodology for determining appropriate staffing and physical resources in a clinical environment using this simulation model. This methodology takes advantage of several simulation-based statistical techniques, including batch means: fractional factorial design: and simultaneous ranking, selection, and multiple comparisons. A clinic effectiveness measure is introduced that captures several objectives within a health care clinic, including profitability and patient satisfaction. An explanation of the experimental design is provided and results of the experimentation are presented. Based upon the experimental results, conclusions are drawn and recommendations are made for an appropriate staffing and facility size for a two physician family practice healthcare clinic.

摘要

随着来自政府和保险机构的压力不断增加,如今的医生用于患者护理的时间减少,而用于行政事务的时间增多。为了帮助医生诊所评估能够提高运营效率并更好地满足患者需求的潜在操作流程,使用可视化仿真环境(VSE)构建了一个面向对象的离散事件仿真模型。本文所呈现的研究描述了一种使用该仿真模型来确定临床环境中适当人员配备和物力资源的方法。该方法利用了几种基于仿真的统计技术,包括批均值法、分式析因设计以及同时排序、选择和多重比较。引入了一种诊所效能度量方法,该方法涵盖了医疗诊所内的多个目标,包括盈利能力和患者满意度。文中提供了实验设计的解释,并展示了实验结果。基于实验结果得出结论,并针对一家拥有两名医生的家庭医疗诊所的适当人员配备和设施规模提出了建议。

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