论文标题

优化各个地区的医院分配,以减少结核病死亡

Optimizing hospital distribution across districts for reducing tuberculosis fatalities

论文作者

Lee, Mi Jin, Kim, Kanghun, Son, Junik, Lee, Deok-Sun

论文摘要

通常从通勤距离或经济利润的优化来理解不同设施的空间分布。将更一般的目标功能纳入这种优化框架可能很有用,有助于政策决策以满足各种社会和经济需求。例如,我们考虑应如何分配医院,以最大程度地减少结核病的总死亡(TB)。韩国的经验数据表明,一个地区的死亡率随着医院的面积密度而降低,这意味着它们的相关性以及通过调整各个地区的医院分配来减少全国性死亡的可能性。患者的概率近似于死亡率,不在结核病的持续时间内访问其住宅区的医院,并评估随机步行框架中后者的概率,我们将死亡率作为医院密度的指数功能,其特征性常数与每个地区的有效效果恒定可估计的频率相关。这使我们达到了最佳的医院分布,发现一个地区的医院密度是重新恢复的患者密度的对数功能。最佳的总死亡人数减少了13 \%。当前的医院密度偏离了从地区到地区的不同举止优化的,这在拟议的模型框架中进行了分析。还讨论了我们研究的假设和局限性。

The spatial distributions of diverse facilities are often understood in terms of the optimization of the commute distance or the economic profit. Incorporating more general objective functions into such optimization framework may be useful, helping the policy decisions to meet various social and economic demands. As an example, we consider how hospitals should be distributed to minimize the total fatalities of tuberculosis (TB). The empirical data of Korea shows that the fatality rate of TB in a district decreases with the areal density of hospitals, implying their correlation and the possibility of reducing the nationwide fatalities by adjusting the hospital distribution across districts. Approximating the fatality rate by the probability of a patient not to visit a hospital in her/his residential district for the duration period of TB and evaluating the latter probability in the random-walk framework, we obtain the fatality rate as an exponential function of the hospital density with a characteristic constant related to each district's effective lattice constant estimable empirically. This leads us to the optimal hospital distribution which finds the hospital density in a district to be a logarithmic function of the rescaled patient density. The total fatalities is reduced by 13\% with this optimum. The current hospital density deviates from the optimized one in different manners from district to district, which is analyzed in the proposed model framework. The assumptions and limitations of our study are also discussed.

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