The MDP Model Of Patient Admission Decision Considering Premature Discharge Policy And Balking Behavior

With the continuous improvement of Chinese economic level and the change of population structure,people’s demand for medical resources is increasing day by day.As the main provider of medical services in China,large public hospitals are equipped with more professional medical level and equipment.As a result,they are faced with the situation that medical resources are in short due to the huge flow of patients.Bed as one of the important medical resources has a high average utilization rate in large public hospitals.It’s important to solve the contradiction between supply and demand of hospital beds urgently.Faced with this contradiction,hospital departments can adopt effective decision-making methods to manage hospitalized patients,so as to improve the effective utilization rate of hospital beds and patients’ satisfaction.Therefore,it is of great significance to study the decision-making of admission of patients in the single department of large public hospital.This article based on the summary of the domestic and foreign studies on the patient admission decision,studied a more in-depth on the patient admission decision of single-department in large public hospitals.From the previous research results,the research on patient admission decision mainly focuse on patient admission appointment scheduling,while there are few studies on patient admission allocation scheduling.And in a few studies,the premature discharge policy and patient balking behavior are seldom considered.Therefore,this article puts forward the patient admission problem considering premature discharge policy and balking behavior from the hospital situation of patients with acute and chronic diseases.Then building the corresponding infinite-horizon continuous-time discount revenue Markov decision process model to get the patient admission policy in specific circumstances.The main work of this article is as follows:(1)The admission problem using premature discharge policy of patient with acute disease in large public hospital was refined.Then using the Markov decision-making process to simulate the admission decision-making of patients.This article describes the problem of admission decision using premature discharge policy and builds infinite-horizon continuous-time discount revenue Markov decision-making process model to maximize the expected total revenue of the department according to the characteristics of the problem.Finally designs the solution method of the model.(2)The admission problem considering balking behavior of patient with chronic disease in large public hospital was refined.Then using the Markov decision-making process to simulate the admission decision-making of patients.This article describes the problem of admission decision considering balking behavior and builds infinite-horizon continuous-time discount revenue Markov decision-making process model to maximize the expected total revenue of the department according to the characteristics of the problem.Finally designs the solution method of the model.(3)The patient admission problem considering premature discharge policy and balking behavior is analyzed by examples respectively.The admission policy shows the effectiveness of the proposed method.The proposed patient admission decision problem considering premature discharge policy and balking behavior applied the single department of large public hospitals in this article can effectively alleviate the contradiction between supply and demand of beds,which to improve patients’ satisfaction and maximize the expected total revenue of hospital departments.The research results of this article provide the method and application guidance for the further study of dynamic patient admission decision.