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随着我国城市社区卫生服务网络的建设已初具规模,如何促使患者更多地选择社区卫生服务机构就诊成为至关重要的问题。通过仿真软件Arena建立城市二级医疗机构间患者就诊的流动模型,结合北京市海淀区综合医院和社区卫生服务机构的就诊数据,分析在给予社区转诊到综合医院病人就诊优先权的情况下,患者就医的等待时间、城市二级医疗机构间各类医疗机构利用率的变化。同时,以最大化治疗病人数为目标,结合考虑各类医疗机构利用率平衡的情况下,计算出社区卫生服务机构分流患者的最优比例,以期为政府进行患者流控制与管理提供参考。仿真结果从患者角度证明了转诊优先的激励政策能缩短其就诊的等待时间,从系统的角度验证了社区首诊制能给城市医疗系统带来的效率提升。
With the construction of urban community health service network in our country has begun to take shape, how to encourage patients to choose more community health service institutions has become a crucial issue. Through the simulation software Arena to establish the flow model of patient visits between urban secondary medical institutions, combined with the treatment data of Haidian District General Hospital and community health service agencies in Beijing, the author analyzes the priority of referral to patients in general hospitals from the community, The waiting time for medical treatment, the changes of the utilization rates of various medical institutions in urban secondary medical institutions. At the same time, with the goal of maximizing the number of patients to be treated and considering the balance of utilization rate of various medical institutions, the optimal proportion of patients shunted in community health service institutions was calculated, which could provide reference for the government to control and manage patient flow. The simulation results demonstrate from the patient’s point of view that referral-priority incentive policies can shorten the waiting time for their visits and validate the efficiency improvement that the community first diagnosis system can bring to the city medical system from a systematic perspective.