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面向定制化医疗服务的患者细分与资源分配

Patient segmentation and resource allocation for tailored healthcare delivery

Journal of the Operational Research Society · 2025
被引 0
ABS 3

中文导读

提出一种利用患者细分技术解决医疗资源分配问题的方法,通过无监督学习识别患者群体、生成规则化推荐并设计优先级评分,帮助在缺乏先验数据时规划新医疗项目,案例显示可提升资源效率与护理效果。

Abstract

Healthcare systems often face the challenge of providing quality care to a diverse patient population while effectively utilizing limited resources. While some patients with complex conditions may require specialized care at dedicated clinics, others could benefit from receiving treatments at home, rehabilitation centers, community health centers, or other tailored service programs. Evaluating resource allocation and directing patients to appropriate care settings are particularly important when planning new healthcare initiatives with limited prior data or operational experience. This work introduces a methodology that uses patient segmentation techniques to address the challenges of resource allocation in healthcare settings, specifically focusing on planning new programs that lack prior data or clinical experience by leveraging existing electric patient records. First, we use unsupervised learning, specifically ensemble clustering, to identify distinct groups of patients. Next, an algorithm for rule-based representation of clusters is proposed to generate simple data-driven recommendations that can be applied to practical settings for selecting target patient groups, and lastly, we introduce a resource delivery priority score function that can guide decision-making and patient prioritization under resource constraints. Our methodology is applied to a case study of home transfusion delivery of Red Blood Cell (RBC) products, a proposed program for patients who are required to regularly visit outpatient clinics for receiving transfusions. The results highlight the potential of our methodology in efficient resource allocation and improving patient care outcomes beyond the current heuristic-based approaches in clinical practice.

医疗保健资源分配患者细分运营管理人工智能