臺灣博碩士論文加值系統

感染症發生時，往往因為人們的缺少防疫物資的防護，而在短時間內造成感染症疫情迅速擴散。例如九十二年初之嚴重急性呼吸道症候群(SARS)，從世界衛生組織正名後，在三個月時間內就造成了全球八千四百餘例的病例數與近八百人的死亡，卻沒有一個國家能真正的做出有效的防疫處置措施，抑制感染症疫情之擴散。
而醫療院所亦因防疫物資缺貨且無法有效配送管理防疫物資，造成醫療院所基層護理人員心理壓力及政府機關、一般民眾爭相搶購防疫物資，更有業者趁此機會哄抬物價。因此本研究將針對防疫物資存貨途程問題，建構以感染症擴散模型、供應商存貨管理、禁忌搜尋法為基並且應用模糊理論描述問題環境之「感染症防治醫療網防疫物資配送管理模式」，作為確保防疫物資充分供應及防疫物資之掌控，俾有效阻斷病毒在醫療院所散播，保障醫療人員及民眾健康，亦能有效保障防疫物資供應商之權益。經由本研究之模糊實驗結果發現，於總配送物流作業成本為主要績效指標情況下，本研究所提出之防疫物資配送管理模式，明顯較現行作業方式為佳，並瞭解到當感染症責任醫療院所數目與防疫物資品項數目大小不同組合下，均顯示優異之結果。

When the infectious diseases outbreak, it always be endemic in a short time because people don’t pay attention to epidemic prevention goods. For example, Severe Acute Respiratory Syndrome causes about eight thousands and four hundreds suspect cases and eight hundreds people death in the world from World Health Organization identified the infectious diseases. In the same time everyone has live in the menace of infectious diseases and no people know what is the best methods of control infectious diseases.
And hospitals of medical treatment of infectious diseases don’t have enough epidemic prevention goods and the vendor of epidemic prevention goods also can’t provide good service of epidemic prevention goods distribution. So our research plan focus on “ inventory routing problem “ of epidemic prevention goods. We introduce “ Vendor Management Inventory “ , ”Epidemic Propagation Model” and the “ Fuzzy Theory ” to develop a distribution model of epidemic prevention goods. And we can make sure epidemic prevention goods could be supply enough and management health of medical professional. Through the research outcome, we can find that in the situation of taking total logistic operation cost as master achievement index, we provide distribution model of epidemic prevention goods created by our research is obviously better than the method at present. We also can find that our distribution model of epidemic prevention goods has superior expression in the combinations of different hospitals of medical treatment of infectious diseases quantities and items of epidemic prevention goods quantities scale.

目錄
摘要 I
目錄 IV
第一章、緒論 1
1.1研究動機與背景 1
1.2研究目的 3
1.3研究範圍與假設 4
1.4研究方法 5
第二章、文獻探討 7
2.1感染症防治醫療網 8
2.1.1感染症醫療體系 8
2.1.2感染症相關定義與分類 10
2.2感染症擴散模型原理 11
2.3模糊理論概述 14
2.3.1模糊集合 14
2.3.2模糊集合基本運算 15
2.3.3模糊數排序 15
2.3.4模糊評判 19
2.3.5解模糊化 21
2.4供應商存貨管理 23
2.5傳統車輛途程問題與存貨途程問題 26
2.5.1傳統車輛途程問題與其解法 26
2.5.2存貨途程問題 27
2.6禁忌搜尋法 29
第三章、感染症防治醫療網防疫物資配送模式之建構 32
3.1感染症防治醫療網防疫物資配送模式架構 32
3. 2數學模式 35
3.2.1符號定義 35
3.2.2模式建立 38
3.3模式解析 42
3.3.1解析(3-25)式 43
3.3.2解析(3-26)式 45
3.4小結 47
第四章、感染症防疫物資配送管理模式之決策面架構說明 48
4.1以二階程序為導向之感染症防疫物資配送演算法架構 48
4.2模糊排序法 54
4.3 防疫物資配送管理演算法的演算流程 55
4.4 防疫物資配送管理演算法數值計算範例 63
第五章、模擬實驗與績效分析 72
5.1模擬實驗相關設定 72
5.1.1 感染症防治醫療網之防疫物資配送管理中心相關條件設定 72
5.1.2 實驗因子設定 76
5.1.3 實驗編碼說明 77
5.2 目前現行物資配送方式與本研究所提之防疫物資配送管理模式之比較 78
5.2.1實驗說明 78
5.2.2實驗結果 79
5.2.3顯著性分析 81
5.2.4小結 81
5.3 防疫物資配送管理模式相關因子之敏感度分析 82
5.3.1 變動專責醫療院所數目與防疫物資品項數目 82
5.3.2 變動感染症擴散率水準 84
5.3.3變動危險加給成本等級 88
5.3.4 變動安全存貨率水準 90
5.4本章結論 95
第六章、結論與未來展望 96
6.1結論 96
6.2未來發展方向 97
參考文獻： 98
附錄一、防疫物資管控流程圖 101
附錄二、修正防疫物資管控流程圖 102
附錄三、SARS治療及發燒篩檢防護配備需求建議一覽表 103

＜中文部份＞
【1】「商業快速回應技術手冊」, 1998, 經濟部商業司
【2】供應鏈之設計與管理-觀念、策略、個案, 2001, 蘇雄義譯，麥格羅希爾
＜英文部份＞
【3】Angelelli, E., and Speranza, G., 2002, “The Periodic Vehicle Routing Problem With Intermediate Facilities”, European Journal of Operational Research, Vol.137, pp.233-247.
【4】Badeau, P., Guertin, F., Gendreau, M., et al. 1997, “A parallel tabu search heuristic for the vehicle routing problem with time windows”, Transportation Research Part C: Emerging Technologies, Vol. 5, Issue 2, April, pp. 109-122
【5】Bard, H., Jaillet, P., and Dror, M., 1998, “A Decomposition Approach to the InventoryRouting Problem with Satellite Facilities”, Transportation Science, Vol. 32, pp.189-203
【6】Battiti, R., and Tecchiolli G., 1994, “The reactive tabu search”, ORSA Journal on Computing, Vol.6, Issue, 2, pp.126-140
【7】Bodin, L., and Golden, B., 1981, “Classification In Vehicle Routing And Scheduling”, Networks, Vol. 11, pp. 97-108
【8】Bodin, L., Golden, B., Assad, A., et al. 1983, “Routing and Scheduling of Vehicles and Crews the state of the art “, Computers & Operations Research, Vol. 10, No. 2.
【9】Brandao, J., and Mercer, A., 1997, “A Tabu Search Algorithm for the Multi-trip Vehicle Routing and Scheduling Problem”, European Journal of Operational Research, Vol. 100, pp.180-191
【10】Buzzell, R., and Ortmeyer, G., 1995, “Channel Partnerships Streamline Distribution”, Sloan Management Review, Vol. 36, pp. 85-96
【11】Campbell, A., Clarke, L., Kleywegt, A., et al. 1998, “The Inventory Routing Problem”, In T. Crainic and G. Laporte , editors, Fleet Management and Logistics, Kluwer Academic Publishers.
【12】Cadenas, J.M., and Verdegay, J.L., 1997, “Using Fuzzy Number in Linear Programming”, IEEE Transaction on Systems, Man, and Cybernetics-Part B: Cybernetics, Vol. 27, No. 6, pp.1016-1022.
【13】Cerny, V., 1985, “Thermodynamical Approach to the Traveling Salesman Problem: An Efficient Simulation Algorithm”, Journal of Optimization Theory and Applications, Vol. 45, pp. 41-51
【14】Chao, I., Golden, B., and Wasil, E., 1995, “An Improved Heuristic for the Period Vehicle Routing Problem”, Networks, Vol. 26, pp. 25-44
【15】Chen, F., Drezner, Z., Ryan, J. k., et al. 2000, “Quantifying the Bullwhip Effect in a Simple Supply Chain: the Impact of Forecasting, Lead Times and Information”, Management Science, Vol. 46, pp. 436-443.
【16】Cheng, and Ching-Hsue, 1998, “A New Approach for Ranking Fuzzy Numbers by Distance Method”, Fuzzy Sets and System, Vol. 95, pp. 307-317.
【17】Chien, T., Balakrishnan, A., and Wong, R., 1989, “An Integrated Inventory Allocation and Vehicle Routing Problem”, Transportation Science, Vol. 23, pp. 67-76
【18】Chu Ta-Chung, and Tsao Chung-Tsen, 2002, “Ranking fuzzy number with an area between the centroid point and original point”, Computer and Mathematics with Applications, Vol. 43, Issue: 1-2, January, pp. 111-117.
【19】Clemmet, A., 1995, “Demanding Supply”, Work Study, Vol. 44, No. 7, pp. 23-24
【20】Cordeau, J., Gendreau, M., and Laporte, G., 1997, “A Tabu Search Heuristic for Periodic Multi-Depot Vehicle Routing Problems”, Networks, Vol. 30, pp. 105-119
【21】Chu Ta-Chung, and Tsao Chung-Tsen, 2002, “Ranking fuzzy numbers with an area between the centroid point and original point”, Computers and Mathematics with Applications, Vol. 43, Issue:1-2, January, pp. 111-117
【22】Dennis, G., Zill, and Michael, R., Cullen, 1996, “Differential Equations with Boundary-value Problems”, published by Brooks Cole, 4th edition.
【23】Dong, Y., and Xu, K., 2002, “A Supply Chain Model of Vender Managed Inventory”, Transportation Research Part E, Vol. 38, pp. 75-95
【24】Glover, F., Taillard, E., and DeWerra, D., 1992, “A User’s Guide to Tabu Search”, Annals of Operations Research, Vol.59, pp.231-247
【25】Kjetil, Fagerholt., 1999, “Optimal fleet design in a ship routing problem”, International Transactions in Operational Research, Vol. 6, Issue: 5
【26】Kleywegt, A., Nori, V., and Savelsbergh, M., 2002, “The Stochastic Inventory Routing Problem with Direct Deliveries”, Transportation Science, Vol. 29, No. 3,
【27】Lee, H., Padmanabhan, P., and Whang, S., 1997, “Information Distortion in a Supply Chain: the Bullwhip Effect”, Management Science, Vol. 43, pp. 546-558.
【28】Liou Tian-Shy and Wang Mao-Jiun 1992, “Ranking fuzzy numbers with integral value”, Fuzzy sets and system, Vol. 50, pp.247-255
【29】Miyamoto, Y., and Kubo, M., 2001, “Case Study : The Inventory Routing For Vending Machines”, Journal of the Operation Research, Vol. 44, No. 4 pp.378-389.
【30】Petch, J., and Salhi, S., 2003, “A multi-phase constructive heuristic for the vehicle routing problem with multiple trips”, Discrete Applied Mathematics, Vol. 133, pp. 69-92.
【31】Shih, L. H., and Chang, H. C., 2001, “A Routing and Scheduling System for Infectious Waste Collection”, Environmental Modeling and Assessment, Vol. 6, pp.261-269
【32】Sun, J., Ge P. and Liu, Z., 2001, “Two-grade fuzzy synthetic decision making system with use of an analytic hierarchy process for performance evaluation of grinding fluids”, Tribology International, Vol. 34, pp.683-688.
【33】Zadeh, L.A., 1965, “Fuzzy Sets”, Information and Control, Vol. 8, No. 3, pp.338-353.
＜網站部份＞
【34】行政院衛生署全球資訊網，http://www.doh.gov.tw/cht/index.aspx。
【35】衛生署疾病管制局全球資訊網，http://www.cdc.gov.tw/index1024.htm。
【36】傳染病之擴散模型，http://episte.math.ntu.edu.tw/applications/ap_epidemic。