Research On Hospital Selection For Downward Referral In Hierarchical Diagnosis And Treatment Based On Multiple Attribute Decision Making

Although many achievements have been made since the implementation of hierarchical diagnosis and treatment system,due to China’s national conditions and residents’ medical habits,many patients with common diseases tend to go to large hospitals,and the process of patients’ treatment is "easy to turn up and difficult to turn down".Clustering large hospitals aggravates the unreasonable allocation of medical resources.It is the focus of hierarchical diagnosis and treatment to promote patients’ referral from large hospitals to lower hospitals.The selection of hospital is an important part of downward referral,but the research on this problem is relatively small.Most scholars study the current situation and countermeasures of downward referral,policy awareness,and factors affecting downward referral.With the construction of the Medical Association,most of the patients who are diagnosed and treated in the tertiary hospitals are willing to be transferred to the secondary hospitals or community hospitals when they are in remission or recovery period.It is beneficial to implement the two-way referral system to let patients participate in the downward referral as decision-makers.Based on the existing research,this paper proposes the hospital selection problem of downward referral,and solves the problem from the perspective of multi-attribute decision-making.A perfect index system is the basis of multi-attribute decision-making problem.Through literature analysis,expert evaluation,questionnaire survey and other methods,this paper constructs an index system to evaluate the downward referral hospital from the combination of qualitative and quantitative methods,which is the basis of research on the selection of downward referral hospital.In the field of multi-attribute decision-making,q-Rung orthopair fuzzy uncertain linguistic set is a hot topic in the research of multi-attribute decision-making,which is more widely expressed than other fuzzy sets and is suitable for representing the evaluation information of patients,In this paper,the Schweizer Sklar hamy mean power aggregation operator is used to fuse the q-Rung orthopair fuzzy uncertain linguistic numbers for the first time,and the information fusion operator is deduced and its properties are demonstrated,and the multi-attribute decision-making model is constructed to solve the research problems proposed in this paper.Finally,based on the evaluation index and multi-attribute decision-making model,the actual downward referral cases are selected to make decision,which proves the effectiveness and superiority of the proposed method.The main achievements of this paper are as follows:(1)the evaluation index system of hospitals transferred to lower hospitals is constructed: the evaluation index system of hospitals transferred to lower hospitals is the basis of multi-attribute decision-making problem,and there is no complete evaluation index system of hospitals transferred to lower hospitals.(2)This paper constructs a decision-making model of downward referral hospital selection: Based on q-Rung orthopair fuzzy uncertain linguistic set theory,Schweizer Sklar rule,power mean and hamy mean operator,four information fusion operators are proposed,and the properties of these four operators are studied,and a decision-making model based on information fusion operator is proposed.(3)The effectiveness and superiority of the model are proved: Based on the evaluation index system and the decision-making model of q-Rung orthogonal fuzzy uncertain semantic Schweizer Sklar power hamy mean operator obtained in this study,the case of cerebral apoplexy patients in the actual scene is studied,and the decision-making of hospital selection in the process of stable downward referral is made,The sensitivity and effectiveness of the decision model are analyzed to prove the practicability of the proposed method.The research of this paper has innovation and guiding significance in the theory and practice of hierarchical diagnosis and treatment.This paper constructs an evaluation index system for the selection of referral hospitals in the hierarchical diagnosis and treatment system,which provides a solution for the hierarchical diagnosis and treatment management;The properties and model of q-Rung orthopair fuzzy uncertain linguistic Schweizer Sklar power hamy mean operator are studied,which provides a new solution for multi-attribute group decision-making.The actual case analysis shows that the decision-making model proposed in this paper can effectively make decisions on hospital selection.