面對高昂的醫(yī)療費用和日益增長的醫(yī)療需求,有效配置醫(yī)療資源并提高醫(yī)療系統(tǒng)的運作效率變得越來越重要�；谶\籌優(yōu)化方法,本文重點研究了醫(yī)療運作管理中的三類問題,即:考慮麻醉復蘇室床位有限時的手術調度問題;單個醫(yī)護團隊服務的家庭醫(yī)療路徑規(guī)劃和預約調度問題,以及多個醫(yī)護團隊服務的家庭醫(yī)療路徑規(guī)劃和預約調度問題。手術病人在完成手術后必須被快速轉移到麻醉復蘇室進行術后復蘇。當麻醉復蘇室床位有限時,病人在完成手術后可能會由于復蘇室中沒有空余的床位而滯留在手術室中,使得后續(xù)的手術被延誤,手術室的使用效率被降低、醫(yī)療團隊的加班成本也有可能因此而增加。為此,本文建立了一個兩階段隨機規(guī)劃模型處理麻醉復蘇室資源有限下的手術調度問題,并考慮了醫(yī)療實踐中病人的手術時間和麻醉復蘇時間通常是不確定的這一重要特征。該兩階段隨機模型中,第一階段優(yōu)化手術的分派和排序,第二階段是一個刻畫了隨機服務時間的離散事件仿真模型。由于標準的隨機規(guī)劃方法（如L型算法）難以在合理的時間內求解實際規(guī)模的問題,本文分析了該模型的若干結構性質,并提出了一個不等式集合以加快算法的收斂速度�；趯嶋H數(shù)據(jù)的計算機實驗表明,本文提出的算法可以在2小時內求... 

【文章來源】：上海交通大學上海市 211工程院校 985工程院校 教育部直屬院校

【文章頁數(shù)】：138 頁

【學位級別】：博士

【文章目錄】：
摘要
abstract
Chapter 1 Introduction
    1.1 Background
        1.1.1 Health care delivery challenges
        1.1.2 Health care operations management
        1.1.3 Operations research in health care
    1.2 Contributions of This Thesis
Chapter 2 A Stochastic Programming Framework for the Surgery Schedul-ing Problem with PACU Capacity
    2.1 Introduction
    2.2 Problem Description
    2.3 Related Literature
    2.4 Problem Formulations
        2.4.1 A two-stage stochastic programming formulation
        2.4.2 A discrete-event simulation model
    2.5 Solution Approaches
        2.5.1 Accelerating solving the MP
        2.5.2 Speeding up the the convergence
    2.6 Numerical Experiments
        2.6.1 Experimental setup
        2.6.2 Computational performance of the proposed algorithms
        2.6.3 Value of considering the PACU capacity
    2.7 Conclusion
Chapter 3 Home Health Care Routing and Appointment Scheduling withStochastic Service Times
    3.1 Introduction
    3.2 Literature Review
    3.3 Problem Statement and Formulation
    3.4 Integer L-Shaped Method
        3.4.1 The lower bound for Q(x)
    3.5 MTSP Heuristic
    3.6 Limited Information Scenario
    3.7 Computational Experiments
        3.7.1 Implementation of the integer L-shaped method
        3.7.2 Experimental setup
        3.7.3 Computational results
    3.8 Conclusion and Discussion
Appendix
    3.A The Mixed Integer Second Cone Program
Chapter 4 Routing and Appointment Scheduling with Caregiver Assign-ment for Home Health Care
    4.1 Introduction
    4.2 Literature Review
    4.3 Problem Description and Mathematical Model
    4.4 Solution Methodology
        4.4.1 Modified parallel savings algorithm
        4.4.2 Tabu Search method
    4.5 Computational Experiments
        4.5.1 Experiments setup
        4.5.2 Comparative experiments
    4.6 Conclusion and Extension
Appendix
    4.A Additional Comparative Experiment Results
Chapter 5 Summary
    5.1 Conclusion
    5.2 Future Work
Bibliography
Acknowledgements
Research Papers
Projects



本文編號：3188164