بهینه‌سازی تخصیص تخت بیمارستانی با رویکرد ترکیبی شبیه‌سازی و تصمیم‌گیری چندمعیاره ی فازی

نوع مقاله : یادداشت فنی

نویسندگان

گروه مهندسی صنایع، دانشکده‌ی‌ برق و کامپیوتر، مجتمع آموزش عالی فنی و مهندسی اسفراین، اسفراین، ایران.

چکیده

تخصیص بهینه‌ی تخت بیمارستان از جمله مسائلی است که نقش مهمی در عملکرد مالی و درمانی بیمارستان دارد. در نوشتار حاضر، با استفاده از رویکرد شبیه‌سازی و درنظرگرفتن سیاست به اشتراک‌گذاری تخت بین بخش‌های مختلف بیمارستان، یک الگوریتم در شش گام توسعه داده شده است. معیارهای در نظر گرفته‌شده، شامل: درصد عدم پذیرش بیمار، استفاده از منبع، و طول صف در بخش‌های مختلف هستند. با توجه به ماهیت غیرقطعی‌بودن مسئله، به‌منظور رتبه‌بندی سناریوها از روش دیمتل فازی استفاده و بهترین سناریو از مجموع سناریوهای ایجادشده انتخاب شده است. سناریوهای مربوط به سطوح مختلف اشتراک‌گذاری، ارزیابی شده و بهترین سناریو و میزان درصد اشتراک‌گذاری تخت به‌دست آمده است. در بهترین سناریوی انتخابی، میزان چهار معیار اصلی انتخابی به ترتیب برابر با: 5/9%، 70%، 19، و 2/1 نفر به‌دست آمده است. مدیران بیمارستان می­توانند با استفاده از نتایج سناریوهای بهینه، عملکرد کلی واحد درمانی را بهبود بخشند.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Optimization of Hospital Bed Allocation by a Hybrid Simulation-MCDM Approach

نویسندگان [English]

  • Sara Motevali haghighi
  • Ali Ghorbanian
Department of Industrial Engineering, Faculty of Electrical and Computer Engineering, Esfarayen University of Technology, Esfarayen, Iran
چکیده [English]

Hospitals are one of the key parts of the health system that are responsible for providing services to patients. The optimal allocation of hospital beds is one of the important issues that plays a significant role in the financial and clinical performance of hospitals. Therefore, in this article, an algorithm in six main steps, including data collection, simulation, scenario definition, simulation model execution, calculation of the importance degree of output variables, and ranking of scenarios, has been developed using a computer simulation approach and considering the bed-sharing policy among different hospital departments. The main criteria considered in this study include patient rejection (PR), the percentage of resource utilization (RU), and the length of the queue (LQ). Due to the nature of uncertainty in the problem, a fuzzy DEMATEL method has been used for ranking scenarios. Finally, the best scenarios have been identified from the total scenarios considered, which can be taken into account by hospital managers in decision-making to improve the overall performance of their medical unit using optimal scenario assumptions. The presented algorithm has been investigated on a case study, and its results have been analyzed and reviewed. The considered case study hospital has two inpatient departments. The first department is designated for triage patients and first-type clinic patients, while the second department is for second-type clinic patients. In the conducted case study, the weights of each decision criterion are 0.33, 0.09, 0.27, and 0.30, respectively. A total of 36 scenarios have been defined for the case study. In the end, based on the developed model, scenario number 20 has been chosen as the best scenario. In this scenario, the percentage of patient rejection for triage is 9/5%, the resource utilization percentage is 70%, and the average number of people waiting in line for first and second-type clinic patients is 19.73 and 1.27, respectively.

کلیدواژه‌ها [English]

  • Optimization
  • resource allocation
  • hospital bed
  • computer simulation
  • multi-criteria decision making

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