紧急医疗服务公平约束调度模型

IF 1.6 Q3 MANAGEMENT
Sreekanth V.K., Ram Babu Roy
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引用次数: 6

摘要

目的本文的目的是将基于代理的建模和仿真概念应用于评估在有限理性下解决救护车调度决策问题的不同方法。本文研究了过度反应(即即使为可疑的高危患者派遣救护车)对公平约束的紧急医疗服务绩效的影响。设计/方法论/方法基于Agent的建模和仿真用于评估两种不同的调度策略:第一,基于最大回报的策略,第二,基于马尔可夫决策过程公式的策略。使用了四个公平约束:两个来自患者方,两个来自提供者方。结果使用价值迭代方法求解的马尔可夫决策过程公式在服务患者数量方面优于最大奖励方法。由于股权约束相互冲突,一次最多可以执行三个股权约束。研究表明,如果患者的风险水平存在不确定性,过度反应是安全的。研究局限性/影响需要进一步研究,以了解反应不足的影响,即可疑的高危患者被拒绝救护车服务。实际影响良好的分流系统的必要性是显而易见的,因为过度反应严重影响了业务预算。该模型可用于评估各种调度策略决策。社会影响从患者和服务提供者的角度来看,紧急医疗服务必须确保有效和公平地提供服务。原创性/价值本文将基于代理的建模应用于股权约束的紧急医疗服务,并强调了现有文献中没有报道的发现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Equity-constrained dispatching models for emergency medical services
Purpose The purpose of this paper is to apply agent-based modeling and simulation concepts in evaluating different approaches to solve ambulance-dispatching decision problems under bounded rationality. The paper investigates the effect of over-responding, i.e. dispatching ambulances even for doubtful high-risk patients, on the performance of equity constrained emergency medical services. Design/methodology/approach Agent-based modeling and simulation was used to evaluate two different dispatching policies: first, a policy based on maximum reward, and second, a policy based on the Markov decision process formulation. Four equity constraints were used: two from the patients’ side and two from the providers’ side. Findings The Markov decision process formulation, solved using value iteration method, performed better than the maximum reward method in terms of number of patients served. As the equity constraints conflict with each other, at most three equity constraints could be enforced at a time. The study revealed that it is safe to over-respond if there is uncertainty in the risk level of the patients. Research limitations/implications Further research is required to understand the implications of under-responding, where doubtful high-risk patients are denied an ambulance service. Practical implications The need for good triage system is apparent as over-responding badly affects the operational budget. The model can be used for evaluating various dispatching policy decisions. Social implications Emergency medical services have to ensure efficient and equitable provision of services, from the perception of both patients and service providers. Originality/value The paper applies agent-based modeling to equity constrained emergency medical services and highlights findings that are not reported in the existing literature.
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来源期刊
CiteScore
3.40
自引率
29.40%
发文量
28
期刊介绍: This international journal contributes to the successful implementation and development of work teams and team-based organizations by providing a forum for sharing experience and learning to stimulate thought and transfer of ideas. It seeks to bridge the gap between research and practice by publishing articles where the claims are evidence-based and the conclusions have practical value. Effective teams form the heart of every successful organization. But team management is one of the hardest challenges faced by managers.
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