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考虑患者行为,对医院供应重新分配进行建模以实现公平性。

Modelling the redistribution of hospital supply to achieve equity taking account of patient's behaviour.

作者信息

Oliveira Mónica Duarte, Bevan Gwyn

机构信息

Engineering and Management Department, Instituto Superior Técnico, Technical University of Lisbon, Portugal.

出版信息

Health Care Manag Sci. 2006 Feb;9(1):19-30. doi: 10.1007/s10729-006-6277-7.

Abstract

Policies that seek to achieve geographic equity in countries with a National Health Services (NHS) require information on how to change the distribution of supply to achieve greater equity in access and utilisation. Previous methods for analysing the impact of hospital changes have relied on crude assumptions on patients' behaviour in using hospitals. The approach developed in this study is a multi-modelling one based on two mathematical programming location-allocation models to redistribute hospital supply using different objective functions and assumptions about the utilisation behaviour of patients. These models show how different policy objectives seeking equity of geographic access or utilisation produce different results and imply trade-offs in terms of reduction in total utilisation.

摘要

在拥有国家医疗服务体系(NHS)的国家中,旨在实现地理公平性的政策需要有关如何改变供应分布以在就医机会和医疗服务利用方面实现更大公平性的信息。先前分析医院变化影响的方法依赖于对患者就医行为的粗略假设。本研究中开发的方法是一种多模型方法,基于两个数学规划选址 - 分配模型,使用不同的目标函数和关于患者利用行为的假设来重新分配医院供应。这些模型表明,追求地理就医机会或医疗服务利用公平性的不同政策目标会产生不同的结果,并意味着在总利用率降低方面存在权衡。

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