Collaborative Innovation Center of Health Risks Governance, School of public health, Fudan University, Shanghai 200433, China.
Int J Environ Res Public Health. 2020 Mar 25;17(7):2183. doi: 10.3390/ijerph17072183.
Empirical studies based on patient flow data are needed to provide more materials to summarize the general pattern of patient distribution models. This study takes Shanghai as an example and tries to demonstrate the inpatient flow distribution model for different levels and specialties of medical institutions. Power, negative exponential, Gaussian, and log-logistic models were used to fit the distributions of inpatients, and a model of inpatient distribution patterns in Shanghai was derived, based on these four models. Then, the adjusted coefficient of determination (R) and Akaike information criterion (AIC) values were used to assess the model fitting effect. The log-logistic function model has a good simulation effect and the strongest applicability in most hospitals. The estimated value of the distance-decay parameter β in the log-logistic function model is 1.67 for all patients, 1.89 for regional hospital inpatients, 1.40 for tertiary hospital inpatients, 1.64 for traditional Chinese medicine hospital inpatients, and 0.85 for mental hospital inpatients. However, the simulations at the tumor, children's and maternity hospitals, were not satisfactory. Based on the results of empirical analysis, the four attenuation coefficient models are valid in Shanghai, and the log-logistic model of the inpatient distributions at most hospitals have good simulation effects. However, further in-depth analysis combined with the characteristics of specific specialties is needed to obtain the inpatient model in line with the characteristics of these specialties.
需要基于患者流量数据的实证研究来提供更多材料，以总结患者分布模型的一般模式。本研究以上海为例，尝试展示不同级别和专业医疗机构的住院患者流量分布模型。使用幂函数、负指数函数、高斯函数和对数逻辑函数模型对住院患者的分布进行拟合，并基于这四个模型推导出上海住院患者分布模式的模型。然后，使用调整后的决定系数（R）和赤池信息量准则（AIC）值来评估模型拟合效果。对数逻辑函数模型在大多数医院中具有良好的模拟效果和最强的适用性。对数逻辑函数模型中距离衰减参数β的估计值对于所有患者为 1.67，对于区域医院住院患者为 1.89，对于三级医院住院患者为 1.40，对于中医院住院患者为 1.64，对于精神病院住院患者为 0.85。然而，肿瘤、儿童和妇产科医院的模拟效果并不令人满意。基于实证分析的结果，四种衰减系数模型在上海是有效的，大多数医院的住院患者分布对数逻辑模型具有良好的模拟效果。然而，需要进一步进行深入的分析，并结合特定专业的特点，以获得符合这些专业特点的住院患者模型。
