Research On Medical Service Rescheduling Based On Urgent Patients Disturbing

With the development of the economy,the progress of science and technology,and the improvement of people's living standards,more attention has been paid to physical health.The demand for medical treatment has become personalized and diversified.The medical expenditure and the demand for medical services are constantly increasing.Hospitals are faced with multiple challenges in improving operation efficiency.As one of the important factors of the livelihood project,medical treatment and public health has a great bearing on society stability.Advanced medical service scheduling technology is one of the important factors for hospitals to improve their service capacity and competitiveness.In the practice of medical service scheduling,it is often the case that the occurrence of unexpected conditions results in the interruption of the pre-arranged time and sequence of patient appointments,which call for rearrangement.The common disturbance events include: unexpected attendance of patients,attendance of urgent patients,no-show,lateness of patients,appointment cancellation of patients,medical equipment failure,lateness of doctors,and lack of hospital beds and medical staff and so forth.Based on the characteristics and research status of the relevant theories of the practical medical services scheduling disturbance events,this dissertation focuses on the disturbance events of unplanned emergency patients in medical services,studying the sequence and rescheduling of medical resources of all patients,which include planned patients and unplanned urgent patients.Two kinds of medical service scheduling environments are mainly discussed: the environment in which multiple patients use a single CT for diagnosis,and multiple patients use multiple medical equipment for health examination.The disturbance criteria include: the disturbance quantity constraint of the planned patients' sequence in the rescheduling and the initial scheduling,the disturbance quantity constraint of the completion time of the diagnosis,which is used to measure the influence of the planned patients' satisfaction of the diagnosis.Based on the study of the single-equipment rescheduling of the emergency patients,the preparation/setup time of the medical equipment and other medical resources are taken into consideration for further researches.The main research contents of this paper are as follows:Firstly,the rescheduling problem resulted by the disturbance of emergency patient of the single CT diagnostic service.This issue assumes that the initial scheduling has not been executed when the emergency patients present,and to reschedule the sequence of treatment of patients using that CT equipment,and to minimize the disturbance of the initial scheduling at the same time of satisfying the relative urgent demand of emergency patients.The paper discusses the rescheduling issue with the maximum diagnosis sequence disturbance,total diagnosis sequence disturbance,the maximum diagnosis completion time disturbance and the total diagnosis completion time disturbance as constraints,and the aim of minimizing the scheduling costs of delay penalty of planned patients and diagnosis completion time,which include: the U-RLMT problem with minimizing the maximum delay penalty as the optimization objective,the U-RLTC problem with minimizing the total completion time of diagnosis as the optimization objective,the U-RHTD problem with minimizing the delay penalty and the disturbance costs as the combined optimization objective,and the U-RHCD problem with minimizing the total completion time of diagnosis and the disturbance costs as the combined optimization objective.Under the above mentioned constraints,the paper builds mathematical models,designs algorithm,and analyzes the time complexity of the proposed algorithm respectively in terms of the four optimization objectives.Secondly,the dissertation studies the rescheduling of single CT diagnostic service disturbed by urgent patients which takes the setup time into consideration.Based on the first part of the study,the setup time of medical resources such as medical equipment are taken into account for further research.From the perspective of patient satisfaction,the disturbance constraints include the following factors of the planned patients in the rescheduling relative to the initial schedule,such as the maximum diagnosis sequence disturbance,the maximum absolute diagnosis completion time disturbance and the absolute diagnosis completion time disturbance.In terms of the urgent of medical equipment,the initial schedule of the planned patients aims at minimizing the setup time,and the rescheduling must ensure that the aggregate of the total setup time and disturbance cost is minimized.In accordance with the setup time type and disturbance criteria,five variant problems of this issue are studied:(1)the urgent patient disturbance rescheduling problem with minimizing the original patients' maximum sequence disturbance quantity and minimizing the completion time of all patients as dual optimization objective,setup time family-independent and sequence-independent;(2)the urgent patient disturbance rescheduling problem with minimizing the original patients' maximum absolute completion time disturbance quantity and minimizing the completion time of all patients as dual optimization objective,setup time family-independent and sequence-independent;(3)the urgent patient disturbance rescheduling problem with minimizing the original patients' maximum sequence disturbance quantity and minimizing the completion time of all patients as dual optimization objective,setup time family-dependent and sequence-independent;(4)the urgent patient disturbance rescheduling problem with minimizing the original patients' maximum absolute completion time disturbance quantity and minimizing the completion time of all patients as dual optimization objective,setup time family-dependent and sequence-independent;(5)the urgent patient disturbance rescheduling problem with minimizing the sum of original patients' absolute completion time disturbance quantity and minimizing the completion time of all patients as dual optimization objective,setup time family-dependent and sequence-independent.The polynomial time complexity algorithm is proposed to solve these five kinds of problems in order to get the Pareto-optimal solution.Thirdly,the dissertation studies the rescheduling problem of physical examination medical services triggered by urgent patients' disturbance which takes the setup time into consideration.In this part,the dissertation considers the circumstance with the urgent patients' disturbance,in which multiple patients use multiple medical equipments for physical healthy examination diagnosis,and studies the rescheduling problem(UDHERP-SDS)of urgent patient disturbance with sequence-dependent setup time.The dissertation assumes that the length of setup time of each medical equipment for each patient is sequence-dependent;considers the constraints of a given upper limit for the sequence disturbance of the planned patient in the rescheduling and the initial scheduling;with the optimization objective of minimizing the total diagnosis completion time of all patients and the setup time of equipment,establishes the mathematical model,proposes Hybrid Genetic Algorithm and Simulated Annealing Algorithm based on the characteristics of the problem,and verifies the model and algorithm via the calculation of simulation data.