[1]陈旻洁范颖董恩宏孙晓凡赵旭霁丁粉华张斌渊.基于机器学习法的急诊留观患者分流研究[J].中国卫生质量管理,2021,28(06):035-38.[doi:10.13912/j.cnki.chqm.2021.28.6.10 ]
 CHEN Minjie,FAN Ying,DONG Enhong.Study on Flow of Emergency Observation Patients Based on Machine Learning Method[J].Chinese Health Quality Management,2021,28(06):035-38.[doi:10.13912/j.cnki.chqm.2021.28.6.10 ]
点击复制

基于机器学习法的急诊留观患者分流研究
分享到:

《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R]

卷:
第28卷
期数:
2021年06期
页码:
035-38
栏目:
医疗质量
出版日期:
2021-06-28

文章信息/Info

Title:
Study on Flow of Emergency Observation Patients Based on Machine Learning Method
作者:
陈旻洁范颖董恩宏孙晓凡赵旭霁丁粉华张斌渊
上海交通大学医学院附属仁济医院
Author(s):
CHEN MinjieFAN YingDONG Enhong
Renji Hospital, School of Medicine, Shanghai Jiao Tong University
关键词:
三级综合医院BP神经网络CART分类决策树急诊留观患者流向
Keywords:
Tertiary General HospitalBack Propagation Neural NetworksCART Classification Decision TreeEmergency ObservationPatient Flow
分类号:
R197.323
DOI:
10.13912/j.cnki.chqm.2021.28.6.10
文献标志码:
A
摘要:
目的通过建立急诊留观患者分流预测模型,促进急诊医疗服务管理水平提升。方法通过急诊一体化信息系统收集某三级综合医院2018年7月-2020年6月急诊留观区临床资料,应用机器学习法(BP神经网络和CART分类决策树)建立预测模型,使用SPSS 20.0统计软件和SPSS modeller 18.0统计软件进行数据分析和拟合评估。结果BP神经网络和CART分类决策树模型的分类准确率均达75%以上。急诊留观患者收治病房的影响因素主要有疾病谱、诊断个数、首诊科室、年龄。疾病谱为神经系统或循环系统的患者,收治病房比例相对较高;多系统疾病、诊断个数超过4个或≥80岁的患者,收治病房比例较低。结论应优化急诊重点病种救治流程,通过多学科协作优化床位内部分配和收治机制,加强互联网+医联体协作,改善院外分流措施。
Abstract:
ObjectiveTo establish the prediction model of emergency observation patient flow to improve the emergency medical service.MethodsClinical data from the emergency observation units of a tertiary general hospital were collected from July 2018 to June 2020 through the integrated emergency management information system. The prediction model was constructed using the machine learning method (BP artificial neural network and CART classification decision tree).The SPSS 20.0 software and SPSS modeller 18.0 software were used for data analysis and fit evaluation..ResultsThe classification accuracy of BP artificial neural network and CART classification decision tree method was more than 75%. The main factors predicting the admission ward of the patients under observation were disease spectrum, diagnosis number, receiving medical department and age.Patients with neurological or circulatory disease spectrum had a relatively higher proportion of admitted to the ward. The proportion of patients admitted to the ward was lower in patients with multi-system diseases or diagnoses exceeding 4 or older than 80 years old. Conclusion The emergency treatment process for key diseases should be optimized.The internal allocation and admission mechanism of hospital beds should be optimized through multidisciplinary collaboration. Hospital should make initiatives to strengthen the collaboration of internet plus medical association and improve the measures of out-of-hospital diversion.

参考文献/References:

[1]Asplin BR, Magid DJ, Rhodes KV, et al. A conceptual model of emergency department crowding[J].Annals of Emergency Medicine, 2003,42(2):173-180. [2]Forero R, Mccarthy S, Hillman K. Access block and emergency department overcrowding[J].Critical Care, 2011,15(2):216. [3]黄健.考虑滞留的急救一体化床位资源优化配置研究[D].天津:河北工业大学,2015. [4]杨丽,邱珮琪,王燕,等.上海市级医院急诊医疗服务现状与思考[J].中国医院,2017, 21(1):1-4. [5]杜宁,于广军,范小红.上海市级医院急诊现状分析及优化措施研究[J].中国医院管理, 2010, 30(11):36-37. [6]Du Q, Nie K, Wang Z. Application of entropy-based atribute reduction and an artificial neural network in medicine: a case study of estimating medical care costs Associated with Myocardial Infarction[J].Entropy, 2014, 16(9):4788-4800. [7]Josiah P,Simon KP. Data analytics for Traditional Chinese Medicine Research[M].Switzerland:Springer International Publishing, 2014:123-132. [8]Iang S, Chin KS, Tsui KL. A universal deep learning approach for modeling the flow of patients under different severities[J].Computer Methods and Programs in Biomedicine,2018, 154:191-203. [9]Breiman L , Friedman JH, Olshen RA,et al. Classification and Regression Trees (CART)[J].Biometrics,1984, 40(3):358. [10]李伟.决策树算法应用及并行化研究[D].成都:电子科技大学.2014. [11]周志华.机器学习[M].北京:清华大学出版社, 2016:15-20. [12]江义火,吴昌钱,袁晓建.基于决策树-神经网络的企业客户信用评估模型的构建[J].宁德师范学院学报:自然科学版,2018,30(1):8-14. [13]吴惠静, 陈岚, 黄陈. 急诊分级分区管理模式应用进展分析[J].中国卫生质量管理, 2018, 25(5):7-9. [14]廖生武. 互联网+背景下区域医联体医疗质量管理创新服务模式研究[J].中国卫生质量管理, 2019,26(3):126-129.

相似文献/References:

[1]安凤梅,姚峥,赵国光,等.三级综合医院构建“医联体”健康教育平台实践探讨[J].中国卫生质量管理,2015,22(06):110.
[2]孙晓凡沈骏 陈旻洁.三级综合医院急诊拥挤与医生职业压力研究[J].中国卫生质量管理,2017,24(02):060.[doi:10.13912/j.cnki.chqm.2017.24.2.19]
[3]张海燕 吴志军 霍玉萌 简伟研 么莉.我国三级综合医院护理质量和安全环境现况分析[J].中国卫生质量管理,2019,26(03):009.[doi:10.13912/j.cnki.chqm.2019.26.3.03]
[4]张玉莲宋张骏于忠杨翠萍姜建平李杞峡.医院六位一体后勤管理模式探索与实践[J].中国卫生质量管理,2020,27(04):146.
 ZHANG Yulian,SONG Zhangjun,YU Zhong,et al.Exploration and Practice of Six-Integration Logistics Management Mode[J].Chinese Health Quality Management,2020,27(06):146.
[5]潘晨王瑾.江苏省三级综合医院临床营养科现状调查[J].中国卫生质量管理,2021,28(05):036.[doi:10.13912/j.cnki.chqm.2021.28.5.11 ]
 PAN Chen,WANG Jin.Current Situation Investigation of Clinical Nutrition Departments in Tertiary General Hospitals in Jiangsu Province[J].Chinese Health Quality Management,2021,28(06):036.[doi:10.13912/j.cnki.chqm.2021.28.5.11 ]
[6]徐锡武张静蒋蕴雅侯秀玉.推行门诊电子病历的实践与思考[J].中国卫生质量管理,2021,28(06):010.[doi:10.13912/j.cnki.chqm.2021.28.6.03 ]
 XU Xiwu,ZHANG Jing,JIANG Yunya.Practice and Thinking of Outpatient Electronic Medical Records[J].Chinese Health Quality Management,2021,28(06):010.[doi:10.13912/j.cnki.chqm.2021.28.6.03 ]
[7]李龙倜夏俊琳王娜王梦荷.地市级三级综合医院创伤急救体系探索[J].中国卫生质量管理,2022,29(01):030.[doi:10.13912/j.cnki.chqm.2022.29.1.08 ]
 LI Longti,XIA Junlin,WANG Na.The Trauma First Aid System in Municipal Level Tertiary General Hospital[J].Chinese Health Quality Management,2022,29(06):030.[doi:10.13912/j.cnki.chqm.2022.29.1.08 ]
[8]蔡 慧胡龙军丁明明张 戟钱明平.基于三级综合医院病种特点的临床路径管理[J].中国卫生质量管理,2022,29(03):030.[doi:10.13912/j.cnki.chqm.2022.29.3.09 ]
 CAI Hui,HU Longjun,DING Mingming.Clinical Pathway Management Based on the Diseases Characteristics in Tertiary General Hospitals[J].Chinese Health Quality Management,2022,29(06):030.[doi:10.13912/j.cnki.chqm.2022.29.3.09 ]
[9]黄晓燕周帅侯冷晨许媛媛尚寒冰陈尔真吴宏瞿介明陆勇.上海20家医院住院患者静脉血栓栓塞症防治效果回顾性研究[J].中国卫生质量管理,2022,29(12):038.[doi:10.13912/j.cnki.chqm.2022.29.12.09 ]
 HUANG Xiaoyan,ZHOU Shuai,HOU Lengchen.Retrospective Study on the Prevention and Treatment Effect of Venous Thromboembolism among Inpatients in 20 Hospitals in Shanghai[J].Chinese Health Quality Management,2022,29(06):038.[doi:10.13912/j.cnki.chqm.2022.29.12.09 ]
[10]王敌程晓燕练璐闵晓青刘武.三级综合医院中层行政管理人员胜任力模型构建研究[J].中国卫生质量管理,2023,30(02):093.[doi:10.13912/j.cnki.chqm.2023.30.2.21 ]
 /WANG Di,CHENG Xiaoyan.Construction of Middle-Level Administrative Personnel Competency Model in Tertiary General Hospital[J].Chinese Health Quality Management,2023,30(06):093.[doi:10.13912/j.cnki.chqm.2023.30.2.21 ]

更新日期/Last Update: 2021-06-28