A three-way decision method based on cumulative prospect theory for the hierarchical diagnosis and treatment system of chronic diseases

Abstract

With the increase in the number of patients with chronic diseases, the contradiction between medical resources and the demand for medical services is increasingly stressed. The hierarchical medical system becomes an important measure to efficiently allocate medical resources. Given that the two-way referral of patients is a core issue of a hierarchical medical system, this paper takes the upward referral as an example and constructs a three-way decision model for the hierarchical diagnosis and treatment system of chronic diseases, which takes teleconsultation as a compromise. Firstly, considering the credibility of decision-making information, a new representation of the loss function is proposed by combining the subjective evaluations of doctors with the personal preferences of patients. Secondly, the credibility adjustment rules are designed, subject to the constraints of the loss function. Furthermore, taking into account the doctors’ psychological behaviors such as risk attitudes when facing uncertain decisions, a three-way decision model based on the cumulative prospect theory was constructed. The main highlight and contribution of this paper is to put forward a new form of the loss function and the adjustment method of the loss function. A medical decision support system is designed based on the proposed method. Finally, a real case of upward referral of patients with coronary heart disease in First Hospital of Qinhuangdao is given to illustrate the validity of the proposed method, and comparisons are conducted to show the superiority of the method. This study provides methodical support for the hierarchical diagnosis and treatment system in the medical field, and it is conducive to promoting the equalization of basic medical services, which has potential theoretical and practical significance.