APPLICATION OF FUZZY MATHEMATICS TO MANAGE MEDICAL AND SOCIAL DECISIONS DURING A PANDEMIC
The Bulletin of Contemporary Clinical Medicine · 2022
Abstract. Introduction. The Covid-19 pandemic, which began in early 2020, has changed the organizational foundations of outpatient care and the psychological mindset of patients. Insufficiently informed medical and social decisions led to increasing citizen dissatisfaction with the level of medical care. Mathematical modeling plays a major role in understanding pandemic processes and supporting management decision making. Aim. The aim is substantiation of the choice of the optimal solution for managing the quality of outpatient medical care during a pandemic using mathematical modeling. Material and methods. The material was information about various aspects of the work of polyclinics from 871 questionnaires of a survey of citizens of the city of Omsk of different age categories: group 1 up to 25 years old (n=145), group 2 - 25-55 years old (n=540), group 3 - over 55 years old (n=186). The study protocol was approved by the center’s local ethics committee. Written informed consent was obtained from each participant to participate in the study. The research methodology is based on the theory of fuzzy sets, mathematical modeling, the use of a cognitive approach and simplicial analysis. Results and discussion. Factors influencing the degree of dissatisfaction with medical care have been identified. Possible causal relationships between them are constructed in the form of a cognitive map. A simplicial analysis of the formed cognitive structure and a computational experiment were carried out to observe trends in the development of dissatisfaction with medical care during a pandemic. Gender and age differences were revealed, showing, in particular, that young men have a higher degree of dissatisfaction with medical care (0.6) than women (0.48), but these differences smooth out with age. It was revealed, among other things, that with the improvement of the factor «work schedule of the polyclinic», the factor «dissatisfaction with medical care» is reduced by 2 times. It has been proven that the more significant for the satisfaction of the patient with medical care in the outpatient clinic will be its competent routing at the level of the registry and the general reception room. Conclusion. The use of cognitive technologies and mathematical modeling makes it possible to predict trends in the development of dissatisfaction with medical care when its individual factors change. This is the rationale for the rapid choice of a medical and social solution to eliminate deficiencies, which is extremely important during a pandemic.