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研究生:黃怡詔
論文名稱:建構決策資訊系統及其在醫療服務工程之實證研究
論文名稱(外文):Construction of the Decision Information Systems and Empirical Studies for Medical Service Engineering
指導教授:簡禎富簡禎富引用關係
學位類別:博士
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:2007
畢業學年度:95
語文別:中文
論文頁數:117
中文關鍵詞:決策資訊系統服務工程物流系統基因演算法資料挖礦屬性歸納法主管資訊系統
外文關鍵詞:decision information systemservice engineeringlogisticsgenetic algorithmdata miningattribute-oriented inductionexecutive information system
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由於交通便利與遠距醫療的實施,醫療服務已由傳統門診、住院擴展到遠距醫療與聯合醫療網,而且醫院的經營也由傳統醫病不對等關係轉變成注重顧客滿意度的服務事業,在追求準確、快速的醫療環境中,在醫療照護上,必須仰賴訓練有素的醫護團隊,然而在遼闊的醫療網上,醫療藥品耗材的補充,必須有暢通的物流供應系統,在尋求顧客滿意度上,更必須要有效率的醫療行政輔佐,在醫院未來方向上,充分的決策資訊與決策分析更是必須的。
在服務層次上,服務對象可分為外部顧客與內部顧客兩種,外部顧客是指到醫院或醫院週邊診所接受醫療的病患;內部顧客是指在醫院從事醫療服務的醫院員工,這些都是本研究提出的方案要服務的對象。從問題的本質來看,本研究將針對醫院所面臨的結構化、半結構化與非結構化決策問題做出探討與解決方案,並在某區域教學醫院進行實證研究以驗證研究效度。其中,在科學園區兩百多家廠商,如何在最短的時間蒐集各廠商所需的常備藥品,並且及時送達,本研究提出物流網站的解決方案;在解決病患經常抱怨的看診等候時間過長的問題,本研究針對復健科治療流程整合基因演算法及資料挖礦模式,以縮短病患等候時間,提高病患滿意度;在面臨健保多變的經營環境,如何控制醫療品質與業務量,並由財務構面預測未來醫院經營的方向,本研究提出以醫療資訊系統為基礎的資料庫,經由資料萃取的步驟,提供高階主管各項決策資訊,使醫院能在強烈競爭的環境下穩定成長,本研究由以上三個子問題分別驗證不同類型的決策問題,由解決問題的實證過程中,提昇了醫院的顧客關係與醫療服務品質。
The modern hospital provides not only the outpatient-inpatient health service but also the telemedicine and group occupational service. The enhancement of patient satisfaction has become one of the most issues in the hospital management. In hospital, the improvement of the medical care quality depends on the medical treatment team and the operational excellence of administration team. To prevent from the deficiency of the drugs and material, the hospital has to construct efficient logistics system. In addition, the adequate business information guides the hospital manager to find the best management niche.
This dissertation focused on real settings to develop the solutions to address the structured decision problem, semi-structured decision problem and unstructured decision problem involved in the hospital. Firstly, we set up the logistics web site to be an important entrance of the drug supply chain of the Hsin-Chu science-base industrial park. Secondly, the genetic algorithm and data mining technology have been utilized to improve the scheduling problem of the rehabilitation department. Owing to the shifting environment of the health insurance, the managers of the hospital have to control the business growth and medical cost to decrease the impact of global budget which is executed by Bureau of National Insurance. Thirdly, the executive information system (EIS) is one of the best business tool to predict the development direction of the hospital. The results of these empirical studies have demonstrated practical viability of this study.
目錄

誌謝 …………………………………………………………… I
中文摘要 ……………………………………………………… II
Abstract …………………………………………………… III
目錄 ……………………………………………………………… IV
圖目錄 …………………………………………………………… VII
表目錄 …………………………………………………………… IX
符號表 …………………………………………………………… X
第一章 緒論 …………………………………………………… 1
1.1 究背景與動機 ………………………………………… 1
1.2 研究目的 ……………………………………………… 2
1.3 研究架構及研究步驟………………………………… 5
1.4 論文架構 ……………………………………………… 7
第二章 文獻回顧 ……………………………………………… 8
2.1 物流與知識網站之建立 ……………………………… 8
2.1.1 供應鏈管理 …………………………………………… 8
2.1.2 電子商務 ……………………………………………… 10
2.1.3 知識管理 ……………………………………………… 12
2.2 排程決策 ……………………………………………… 13
2.2.1 醫院排程研究 ………………………………………… 13
2.2.2 混合型現場排程問題 ………………………………… 14
2.2.3 基因演算法 …………………………………………… 16
2.2.4 資料挖礦 ……………………………………………… 18
2.3 主管資訊系統 ………………………………………… 18
2.3.1 主管資訊系統 ………………………………………… 18
2.3.2 主管資訊系統之建構 ………………………………… 20
2.3.3 群體決策 ……………………………………………… 21
2.4 服務工程 ……………………………………………… 22
2.5 小結 ………………………………………………………… 23
第三章 決策資訊系統在醫院結構化問題之實證 …………… 24
3.1 新竹科學園區藥品訂購網站與醫療知識網站……… 24
3.1.1 新竹科學園區醫療網 ……………………………… 24
3.1.2 研究方法 ……………………………………………… 27
3.1.2.1 供應鏈管理導入流程 ………………………………… 27
3.1.2.2 成立專案小組 ………………………………………… 29
3.1.2.3 合約協議 ……………………………………………… 29
3.1.2.4 專案設計 ……………………………………………… 29
3.1.3 保健藥品系統開發 …………………………………… 30
3.1.4 保健藥品作業流程 …………………………………… 32
3.1.5 實際營運 ……………………………………………… 33
3.1.6 知識網站建立 ………………………………………… 33
3.1.6.1 健檢資料自動化流程 ………………………………… 33
3.1.6.2 網站建置 ……………………………………………… 38
3.1.7 稽核評估 ……………………………………………… 41
3.1.7.1 問卷設計 ……………………………………………… 42
3.1.7.2 問卷回收與信度 ……………………………………… 43
3.1.7.3 保健藥品訂購系統分析 ……………………………… 43
3.1.7.4 服務品質分析 ………………………………………… 45
3.1.7.5 假設檢定 ……………………………………………… 45
3.1.8 討論 …………………………………………………… 50
第四章 決策資訊系統在醫院半結構化問題之實證 ………… 51
4.1 問題定義 ……………………………………………… 51
4.2 基因演算法程序 ……………………………………… 53
4.2.1 染色體組成 ………………………………………… 54
4.2.2 初始化過程 ………………………………………… 56
4.2.3 計算適應式函數值 ………………………………… 56
4.2.4 精英策略 …………………………………………… 58
4.2.5 篩選 …………………………………………………… 58
4.2.6 交配 …………………………………………………… 59
4.2.7 突變 …………………………………………………… 60
4.2.8 參數設定 ……………………………………………… 61
4.2.9 終止運算 ……………………………………………… 63
4.2.10 基因演算法效能評估 ………………………………… 64
4.3 資料挖礦 ……………………………………………… 69
4.3.1 區間分群 ……………………………………………… 70
4.3.2 順序屬性 ……………………………………………… 70
4.3.3 治療時間屬性 ………………………………………… 70
4.3.4 剩餘治療時間屬性 …………………………………… 71
4.3.5 儀器負荷屬性 ………………………………………… 71
4.3.6 學習規則歸納 ………………………………………… 72
4.3.7 歸納排序 ……………………………………………… 75
4.3.8 對應新解 ……………………………………………… 77
4.4 基因演算法與資料挖礦求解之比較 ………………… 78
第五章 決策資訊系統在醫院非結構化問題之實證 ………… 84
5.1 研究架構 ……………………………………………… 84
5.1.1 定義需求 ……………………………………………… 84
5.1.2 指標建立與初步設計 ………………………………… 86
5.1.3 細部設計 ……………………………………………… 87
5.1.3.1 資料取得 ……………………………………………… 87
5.1.3.2 資料檢視 ……………………………………………… 87
5.1.3.3 資料格式化 …………………………………………… 88
5.1.4 資料視覺化 …………………………………………… 88
5.1.5 上線使用與系統維護 ………………………………… 89
5.2 實證研究 ……………………………………………… 89
5.2.1 指標設計 ……………………………………………… 89
5.2.2 資料準備與處理 ……………………………………… 90
5.2.3 系統開發 ……………………………………………… 93
5.2.3.1 權限設定 ……………………………………………… 94
5.2.3.2 系統環境建立 ………………………………………… 94
5.2.3.3 資料擷取……………………………………………… 94
5.2.4 功能模組建立………………………………………… 95
5.2.4.1 資訊處理模組………………………………………… 95
5.2.4.2 決策支援模組………………………………………… 97
5.2.4.3 知識管理模組 ………………………………………… 99
第六章 結論與未來研究方向………………………………… 102
參考文獻…………………………………………………………… 105
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