Determining the conditions for reverse triage in emergency medical services using queueing theory
Determining the conditions for reverse triage in emergency medical services using queueing theory
复制标题
利用排队论确定紧急医疗服务中逆向分诊的条件
DOI：
10.1080/00207543.2015.1109718
复制
发表时间：
2016
影响因子：
9.2
通讯作者：
Ong Marcus Eng Hock
中科院分区：
文献类型：
--
作者：
Xie Jingui;Cao Ping;Huang Boray;Ong Marcus Eng Hock
在紧急医疗护理中，有些情况下会优先治疗伤势较轻的伤员，而不是伤势较重的伤员，这就是所谓的逆向分诊。这可能出现在诸如战争的情况下，其中士兵被要求尽快返回战场，或者医疗资源有限的灾难情况下，以便为那些可能生存而不需要先进医疗护理的人节省资源。本文主要研究在时间紧迫的系统中，病人在等待治疗期间病情可能恶化的逆向分诊。建立了一个考虑转移和放弃的卫生保健系统的决策模型。利用平滑率截尾方法，导出了逆向分诊的充分条件，在此条件下，非危重病人得到优先治疗。对于其他条件，最优策略是非常复杂的。我们建议根据系统状态的动态控制策略，而不是任何静态的优先级策略。
In emergency health care, there are situations where the less wounded are treated in preference to the more severely wounded, so calledreverse triage. This may arise in situations such as war where soldiers are required to return to the battlefield as quickly as possible, or disaster situations where medical resources are limited in order to conserve resources for those likely to survive without requiring advanced medical care. This article is to study the reverse triage in time-critical systems, where conditions of patients may deteriorate while waiting for treatment. A queueing model with transfers and abandonments is developed to study the health care system. Using smoothed rate truncation method, sufficient conditions of reverse triage are derived, under which non-critical patients are treated with priority. For other conditions, the optimal policy is very complicated. We suggest a dynamic control policy according to the system state rather than any static priority policies.