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研究生:陳昶旭
論文名稱:醫院健康檢查中心流程之模擬研究
指導教授:桑慧敏桑慧敏引用關係
學位類別:碩士
校院名稱:國立清華大學
系所名稱:工業工程與工程管理學系
學門:工程學門
學類:工業工程學類
論文種類:學術論文
論文出版年:2004
畢業學年度:92
語文別:中文
論文頁數:44
中文關鍵詞:健康檢查模擬再生模式
相關次數:
  • 被引用被引用:22
  • 點閱點閱:1213
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  • 下載下載:296
  • 收藏至我的研究室書目清單書目收藏:2
隨著全民健保開辦,全民對醫療保健的重視與日俱增,健康檢查所強調之”預防大於治療”的觀念也逐漸被民眾接受,然而全民健保所提供的健檢內容並不能滿足民眾對自身健康資訊的需要,因此近年來自費健康檢查的醫療服務開始蓬勃發展,市場的競爭也日趨激烈,健檢中心在提供健檢服務以外更要求高受檢者的滿意度。而不良的健檢流程設計將造成受檢者總檢查時間拉長,引發受檢者抱怨,因此健檢中心欲提高其服務品質,則流程的設計便是一項重要的問題。
本研究以馬偕紀念醫院新竹分院健康檢查中心為研究對象,該中心目前便有流程混亂導致受檢者抱怨的問題存在,本研究首先訂定代表受檢者抱怨的指標:受檢者等候超過特定時間之機率,利用模擬進行不同方案的實驗,同時將得到的結果建立再生模式,得到各績效指標與變因之間的關係式,並依照此模式進行改善方案比較。
本研究主要討論的改善方案包括:現場檢查流程、受檢者報到批次與家醫科醫師開始看診時間與受檢者到來情形的敏感度分析,模擬結果得到應採行最短檢驗時間法則,分上午八點、九點兩批報到,而當預期受檢者遲到情形嚴重時,家醫科醫師於上午九點三十分開始檢查,反之則在九點十分開始檢查,同時健檢中心可以給予承諾,若受檢者在通知時間準時報到,則保證檢查將在兩小時四十分鐘內結束。
Due to the establishing of the National Health Insurance (NHI), people are paying more attention to healthcare and asking for more information about the health status of their own than before. The dissatisfaction of the basic examination provided in the NHI leads to an increasing demand for an integrated health examination at their own expense.
In the competitive market of the integrated health examination, managers are putting more emphasis on customer satisfaction. A bad flow design of the health examination may cause a long total examination time, which leads to a lot of complaints of the customers. For this reason, the flow design becomes an important issue in the health examination centers.
Our research is focus on the health examination center of HsinChu Mackay Memorial Hospital which is facing the flow design problem. In this research, the probability of a customer's waiting time exceeding a specific length was chosen as the criterion for complaints of the customers. The experiments of comparing different strategies were done through simulation, and the output data formed the metamodels which we used to understand the relationship between the criteria and the factors. The comparisons of different strategies are based on the metamodels.
The strategies include the examination flow, the numbers of check-in batches of the customers and the time when the doctor of family medicine begins to diagnosis the customers. A sensitivity analysis of different arrival process of customers is also done. The shortest-processing-time rule of examination flow and two check-in batches are suggested in this research. When most of the customers are late, the doctor of family medicine should begin their diagnoses on 9:30AM, or otherwise the doctor should begin at 9:10AM. The research also shows that a promise to the customers can be mde by the center saying if the customers arrive on time, the total examination time of each individual will not exceed two hours and forty minutes.
1. 緒論 1
1.1. 研究背景與動機 1
1.2. 研究目的 4
1.3. 論文內容與研究流程 5
2. 文獻探討 7
2.1. 健檢服務現況 7
2.2. 模擬在醫療健檢上的應用 10
2.3. 模擬軟體介紹 13
3. 研究方法 17
3.1. 現況描述與系統假設 17
3.2. 模擬實驗與metamodel 19
3.2.1. 輸入分析 20
3.2.2. 模擬實驗 21
3.2.3. 輸出分析 22
3.3. 抱怨率指標 24
3.4. 改善策略 27
3.4.1. 受檢流程 27
3.4.2. 受檢者報到批次 29
3.4.3. 家醫科醫師開始看診時間 29
3.4.4. 受檢者遲到情形之改善 30
4. 研究結果 31
4.1. 受檢流程改善方案 31
4.2. 受檢者報到批次改善方案 32
4.3. 醫師開始看診時間 34
4.4. 受檢者遲到情形之改善 37
5. 結論與建議 39
5.1. 結論 39
5.2. 建議 41
6. 參考文獻 42
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行政院衛生署衛生統計資料網站, http://www.doh.gov.tw/statistic/index.htm
馬偕紀念醫院新竹分院網站, http://www.hc.mmh.org.tw/div_int/health/health01.asp
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