Abstract:

With the improvement of people's living standards and the acceleration of aging process， people's demand for medical resources， especially high-quality medical resources， is growing more faster. However， high-quality medical resources are difficult to increase in the short term. The contradiction between supply and demand of medical resources has brought great difficulties to the implementation of hierarchical diagnosis and treatment policy. Therefore， to ensure the implementation effect of relevant policies， the optimal allocation of medical resources of medical institutions at all levels in the medical alliance under the hierarchical diagnosis and treatment mode， has become an urgent problem to be solved. The patients are divided into mild and severe groups， and the medical treatment process is divided into three stages： diagnosis， treatment and rehabilitation. The medical path of mild and severe patients in the medical alliance is analyzed， and the allocation of medical resources among all levels of medical institutions in the medical alliance under the hierarchical diagnosis and treatment mode is systematically and quantitatively studied. Through the analysis of the operation mechanism of the medical alliance under the hierarchical diagnosis and treatment mode， a more practical queuing network model with priority and blocking is established. In the model， the actual situation such as the classification of patients and the phased medical service process are fully considered， and the medical path of patients in the medical alliance is reconstructed. The results of numerical experiments show that a） in the short term， more patients should be transferred from hospitals to primary medical institutions for rehabilitation. When the referral rate is large， the rehabilitation medical resources of primary medical institutions should be appropriately increased； b） in the long term， mild patients should go to primary medical institutions， and severe patients should go to hospitals. When the quality of primary medical care is improved to a higher level， whether patients are transferred to primary medical service institutions for rehabilitation is related to the service rate of primary medical institutions. Based on the medical and health statistics of a city in 2018， the data of in-hospital treatment of mild and severe patients were set according to the correlation analysis， and the data of transfer rate， service rate and medical resources in the cases were estimated. This study can provide a theoretical basis for policy-making of medical alliance system optimization under hierarchical diagnosis and treatment.

Key words: hierarchical diagnosis and treatment system, queuing network, medical alliance, resource allocation, system optimization