一种分区建模方法,以支持管理可选医院等候名单的战略决策;在英格兰的NHS中应用
Richard M Wood1,2, David J Worthington3
1BNSSG Integrated Care Board, UK National Health Service, 100 Temple Street, Bristol, BS1 6AG, UK. richard.wood16@nhs.net.
Health care management science
|May 13, 2025
概括
通过预测等待时间,一个新的多间隔等待列表模型可以改善选择性医院护理的战略管理. 这种模型与英格兰NHS数据进行了验证,提供了超越以前单间方法的增强洞察力.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 运营研究 运营研究
- 数学建模的数学建模
背景情况:
- 选择性医院护理的有效管理对于患者的治疗结果和资源分配至关重要.
- 现有的单间等待列表模型可以估计列表大小,但不能估计患者等待时间.
- 患者退出等待名单 (离开等待名单) 是简单模型无法完全解决的一个因素.
研究的目的:
- 开发一种能够估计患者等待时间的延长等待列表模型.
- 通过结合时间依赖的区块来解决单个区块模型的局限性.
- 为战略医疗管理提供可扩展和适应的工具.
主要方法:
- 开发一个离散时间的多分区模型,扩展单分区方法.
- 使用一系列微分方程来追踪患者随时间流动的配方.
- 校准与来自英格兰国家卫生服务 (NHS) 等待名单 (年底2023) 的常规数据.
主要成果:
- 多间隔模型成功地估计了等待时间,克服了单间隔的限制.
- 为英格兰NHS等候名单 (2023-2025) 创建了模型预测.
- 后台测试实现了0.4% (6个月窗口) 和4.7% (12个月窗口) 的平均绝对百分比错误 (MAPE),表明预测准确度很强.
结论:
- 拟议的多间隔模型为了解和管理医院等候名单提供了重大进展.
- 该模型预测等待时间的能力支持选择性护理的更好的战略决策.
- 自由可用的开源代码有助于在医疗保健系统中广泛采用和应用.
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