Abstract: Hierarchical diagnosis and treatment is an important part of medical-sanitary system reform, which can make full use of existing medical resources. Therefore, the hierarchy of medical institutions should be considered when selecting medical facilities. This paper uses two levels of medical facilities as the research object of site selection, and establishes a mixed-integer programming model with two-level multi-flow. Given the characteristics of this model, an algorithm based on tabu search is designed to determine the optimal location strategy. Finally, this paper takes the community health service center and regional medical center of a district of Shanghai as the research object. In the case study, a location solution for the corresponding two-level medical facilities is given. An analysis of the influence of related parameters on the siting results is also performed. The algorithm solution results provide assignments to residents who has medical needs, so that the medical resources of the region can be fully utilized and the allocation of medical facilities is more reasonable and balanced.

Key words: medical facilities location, hierarchical diagnosis and treatment, two-level multi-flow model, tabu search algorithm

摘要： 分级诊疗有利于充分利用已有的医疗资源,是医疗卫生体制改革的重要内容,因而在医疗设施选址时需要考虑医疗机构的层级性。本文以两个层级的医疗设施作为选址研究对象,建立了双层级多样流的混合整数规划模型。针对该模型的特点,设计了一种基于禁忌搜索的算法确定最优选址策略。最后,以上海市某区社区卫生服务中心以及区域医疗中心为研究对象,给出相应两个层级医疗设施的选址方案,并对相关参数对选址结果的影响进行了分析。算法求解结果为有就医需求的居民提供指派,使该区域的医疗资源利用率得到了提高,医疗设施配置也更加合理均衡。

关键词: 医疗设施选址, 分级诊疗, 双层级多样流模型, 禁忌搜索算法