School of Management and Economics, Beijing Institute of Technology, Beijing, China.
Telemed J E Health. 2020 Jan;26(1):114-125. doi: 10.1089/tmj.2018.0229. Epub 2019 Apr 17.
Teleconsultation plays an increasingly important role to solve the health care problem in rural areas around the world. Teleconsultation resource optimization has become a new research topic. Given the complex teleconsultation process was difficult to be described by mathematical methods, a queuing simulation model was developed based on the data and teleconsultation empirical flow of Henan Telemedicine Center of China (HTCC) and we used kernel density estimation to solve the problem of arrival rate and service rate of teleconsultation. The data obtained from HTCC included 21,295 teleconsultation records over a 1-year period (February 27, 2016-March 25, 2017). The average waiting time (WT) that primary hospitals requested for teleconsultation was obtained by simulation and compared with empirical average WT to verify this model. We found that Department of Internal Medicine (DIM) WT was the highest and we searched the optimized combination of teleconsultation rooms and DIM experts by sensitivity analyses. The existing resource allocation was not optimal and the hospital managers can improve it to reduce the hospitals' operating costs and the patients' waiting costs. We suggested that the teleconsultation rooms needed at least four and the DIM experts could increase from three to four.
远程咨询在解决全球农村地区的医疗保健问题方面发挥着越来越重要的作用。远程咨询资源优化已成为一个新的研究课题。由于复杂的远程咨询过程难以用数学方法描述，因此我们根据中国河南远程医疗中心（HTCC）的数据和远程咨询经验流程开发了一个排队模拟模型，并使用核密度估计来解决远程咨询的到达率和服务率问题。HTCC 提供的数据包括在一年期间（2016 年 2 月 27 日至 2017 年 3 月 25 日）的 21295 个远程咨询记录。通过模拟获得了基层医院请求远程咨询的平均等待时间（WT），并与经验平均 WT 进行了比较，以验证该模型。我们发现内科的 WT 最高，并通过敏感性分析搜索了远程咨询室和内科专家的优化组合。现有的资源分配不是最优的，医院管理者可以改进它，以降低医院的运营成本和患者的等待成本。我们建议需要至少四个远程咨询室，内科专家可以从三个增加到四个。
