臺灣博碩士論文加值系統

在今日醫療機構競爭日趨激烈，以及政策與制度多元化的醫療環境中，醫院管理者在面對複雜的決策問題時，除了參考專業知識與過去的決策經驗外，更應熟悉如何應用資訊技術以輔助問題解決及決策制定。
過去決策支援系統已有應用在醫療或醫院管理的例子，雖然系統建置方法上有不同的差異性存在，最常見的方法仍是為特定決策目標設計與開發，但是如果抽離該特定決策模式，則顯得適用性不夠。因此，為了克服過去決策支援系統無法任意修改決策目標的性質，我們提出一個構想，意圖建立一個非特定用途之決策支援系統，再由管理者制定其決策知識，賦予該系統的決策任務。所以在研究中，我們同時也提出決策因子與決策知識可以多重遞迴的觀念，以輔助我們做到決策目標多元化之目的。
因此在本篇論文所設計的決策支援系統，可以讓使用者選擇其偏好的決策目標，篩選符合決策目標的資料項目，不但可以藉此決策知識解決決策上之問題，甚至可以讓使用者建立屬於自己的決策知識或是決策模式。而在決策支援系統架構部分，我們允許決策目標由多個決策因子所構成，更可以支援決策目標由多重遞迴關係式的決策因子所構成。
在系統驗證過程中，我們採用醫療方面糖尿病的篩選與醫管方面的門診相關資料統計。從驗證結果得知我們的系統確實可以正確無誤的篩選出符合決策目標的資料項目；除此之外，從多達約400萬筆檢驗資料中篩選糖尿病的例子，我們也發現到一個事實，當資料量越龐大時，雖然總運算時間也隨之增加，但是每一筆資料項目所花費的單位時間則呈現遞減的現象，說明了系統在資料量越龐大時，所需的運算時間相較於資料量小時更具效率。

In this medical conditions, due to the competition among the medical institutions are getting harder and the policy are diversified. The hospital managers, when face the complicate decision problem, shall refer to not only the professional knowledge and experience but also the aid of IT to assist us in decision making and problem solving.
In the past, the decision support system had been developed in the medical area or hospital management. Although the ways of establishing are different, the most common way is to design and implement for particular decisive purpose which suitability is limited if we didn’t apply on particular decisive purpose. For overcoming the past decision support system, which can’t change decisive objective arbitrarily, we propose to establish a decision support system for un-specific purpose, then manager make decisive knowledge and determine decisive purpose. Therefore in this paper, we also bring up an idea, that the decisive factors and decisive objectives could be recursive, to assist us in attaining the goal of decisive purpose diversified.
The decision support system we recommend in this paper could let user chose favored decisive purpose and sift the conformed data, we can solve problems by this way and let user set up themselves decisive purposes. In the structure of decision support system, we allow the decisive purpose, which compose of plenty and recursive decisive factors.
In the verified aspect, we adopt the diabetes example of medical area and the outpatient services statistics of hospital management. From the result, we know our system could sift the conformed data correctly; additionally, we also confirm that if amounts of data are more and more and the total time of processing time increase as well, but the time of an unit of data spending appear in decreasing. This thing explain the system spend time of processing on larger amount of data less then smaller amount of data.

第一章 緒論
一、 研究背景…………………………………………………..1
二、 問題陳述…………………………………………………..4
三、 研究目的…………………………………………………..5
第二章 文獻探討
一、 決策支援系統………………………………………………6
二、 模式庫……………………………………………………..16
三、 彈性………………………………………………………..21
四、 糖尿病………………………………..…………………..30
五、 醫院經營分析……………………………………………..37
第三章 研究架構與方法
一、 研究方法…………………………………………………..43
二、系統架構…………………………………………………..48
三、系統評估方式……………………………………………..59
第四章 研究結果
一、軟體功能說明……………………………………………..60
二、實例資料測試與結果……………………………………..65
第五章 研究限制……………………………………………………..71
第六章 結論與建議
一、研究結論…………………………………………………..73
二、研究建議…………………………………………………..75
參考文獻………………………………………………………………..77

英文部分
1. Alberti K.G.M.M. and Zimnet P.Z. for WHO Consultation, diagnosis and classification of diabetes mellitus and its complications. Part 1：diagnosis and classification of diabetes mellitus. Provisional Report of a WHO Consultation Diabetic Medicine 1998；15：p539-553
2. Alter, S., A Taxonomy of Decision of Decision Support Systems, Sloan Management Review, vol.19, No,1, Fall 1977,pp.39-56.
3. American Diabetes Association. Report of the Expert Committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 1997；20:1183-97.
4. Blanning R.W., Model Management System: An Overview, Decision Support Systems 9, pp.9-18(1993)
5. Booch G., Object-Oriented design with application6. Canning P.S., W.R. Cook,W.L. Hill,W.G. Olthoff, Interfaces for Strongly-typed object-priented programming, OOP-SLA’89 Proceedings, New Orleans,Oct.（1989），p457-467.
7. Chen Y.S., An Entity-Relationship Approach to Decision Support and Expert System, Decision Support System 4, pp.225-234(1988)
8. Dolk D.R., Model Management and Structure Modeling: The Role of an Information Resource Dictionary System, Communication of ACM 31, NO.6, pp.704-718(1988)
9. Dolk D.R. and B. Komsynski, Knowledge Representation for Model Management System, IEEE Transactions on Software Enginerring 10, NO. 6, pp.619-628(1994)
10. Fazlollahi B. et al., Adaptive decision support systems, Decision Support System 20, pp.297-315(1997)
11. Keen, Peter G.. W.and Scott Morton, Michael S. Decision Support System: An Organizational Perspective, Addison-Wesley Publishing Company, Inc., 1978
12. Keen, P. G. W.,”Adaptive Decision for DSS”, Database, VOL. 12,Nos.1-2, Fall 1980, pp.15-25.
13. Krishnan R., Knowledge based aids for model construction, Ph.D Dossertation, The University of Trxas at Austin, TX, Nov. 1987.
14. Kwon O.B. and S.J. Park, RMT:A model support system for model reused, Decision Support System 16, p131-153,1996
15. Lenard M.L., An Object-Oriented Approach to Model Management, Decision Support System 9, pp.677-73(1993)
16. Liang. T.P. “Integrating Model Management with Data Management in Decision Support System”, Decision Support System(1:3), Sepetember 1985, p221-232.
17. Ma J., Type and inheritance theory for model management, Decision Support System 19, pp.53-60(1997)
18. Muhanna W.A., An Object-Oriented Framework for Model Management and DSS Development, Decision Support System 9, pp.217-229(1993)
19. Rizzoli A.E., J.R. Davis and D.J. Abel, Model and data integration and reused in environment decision support system, Decision Support System 24, p127-144,1998
20. Rumbauge J., M. Blaha, W.Premerlani, F.Eddy, W.Lorensen, Object-oriented modeling and design, Prentice_Hall, Englewood Cliffs,NJ, (1991).
21. Scott Morton, Framework for change notification and view synchronization in distributed model management system, IIarvard University,Cambridge, Mass, 1971.
22. Scott Morton M. S. , Management Decision Support System: Computer Based Support for Decision Making, Division of Reasearh, IIarvard University,Cambridge, Mass, 1971.
23. Seprague. R.H. Jr. and Watson. H.J. “Model Management in the MIS”, Proceedings of the 7th AIDS Meeting, 1975, p213-215.
24. Simon, H. A., The New Science of Management Decision. New York, Harper & Row, 1960
25. Sprague R.H., Jr., A Framework for the Development of Decision Support System, in: R.H. Sprague, Jr. and H.J. Watson, Eds., Decision Support System: Putting Theory into Practice, pp. 7-31(Prentice-Hall,1989).
26. Turban E., Decision Support and Expert System: Management Support Systems, 3rd edn. (Macmillan, 1993)
27. Wegner P., Concepts and paradigms of object-oriented programming, OOPS Messenger 1（1）（1990）p7-87.
28. Wu Ing-Long, Model management system for IRT-based test construction decision support system, Decision Support System 27, p443-458（2000）
29. Zhuge Hai, Inheritance rules for flexible model retrieval, Decision Support System 22¸p379-390（1998）
30. Zopounidis C. et al., On the use of Knowledge-bases decision support system in financial management: A survey. Decision Support System 20, pp.259-277(1997)
.
中文參考文獻
1. 丁民國，糖尿病，內科新知，1998，第一卷、第二期，p49-55。
2. 王遠嘉，決策支援系統（DSS）特質之剖析，成功大學社會科學學報第五期（81/12），p229-253。
3. 吳宗藩、謝清佳，資訊管理理論與實務，台北，智勝，1998。
4. 林瑞祥，糖尿病診斷及治療新知，當代醫學，1998，第二十五卷、第七期，p523-526。
5. 秦榮生，模式庫管理，自動化科技，1993年1月，p101-107
6. 徐慧娟、薛亞聖，醫院管理指標的性質與應用，Hospital，2001，p29-41。
7. 許世欣，論病例計酬分類決策支援系統之建構，中國醫藥學院醫務管理研究所，2000。
8. 梁定澎，決策支援系統，台北，松崗出版社，1994。
9. 郭錦松、蔡世澤，糖尿病之診斷及分類的最新標準，臨床醫學1998；42:p31-36。
10. 陳肇真 主編，內科學＜下冊＞第十版，合記圖書出版社，1988。
11. 將瑞清、楊靜倪，醫院管理改革趨勢，管理雜誌第275期，p78-81。
12. 陳楚杰編著，醫院組織與管理第四版，宏翰文化事業有限公司，1996。
13. 廖如龍，決策支援系統發展方法，INFOPRO資訊傳真，1991，p73-75。
14. 鄭志強，現代化醫院管理與企業經營管理，台灣衛生雙月刊 第357期，p50-56。
15. 劉英華、蕭惠卿，以企業管理方法強化醫院管理，黃埔學報35輯，p243-250。
16. 蕭文，醫院管理，醫院.29卷，p14-20。