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研究生:徐綱佑
研究生(外文):Hsu, Kang-Yu
論文名稱:隨機性門診病患之醫療指派規劃系統
論文名稱(外文):A stochastic Clinical Model for Outpatient Scheduling with Patient no-shows and General Service Time
指導教授:桑慧敏桑慧敏引用關係
指導教授(外文):Song, Whey-Ming
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:2010
畢業學年度:98
語文別:中文
論文頁數:66
中文關鍵詞:超額預訂指派規劃病患未出現特徵門診醫療系統
外文關鍵詞:Overbookingappointment schedulingpatient no-showsoutpatient clinics
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醫療服務單位對門診病患的處理效率及門診病患預約指派的及時性,除了是實現良好醫療服務品質的重要因素外,也是病患滿意度的重要評估因素。然而,已預約病患未出現於醫療單位的情況將嚴重影響醫療服務的品質。在本研究中,我們建立一個採用超額訂位(overbooking)策略的隨機性醫療指派規劃模型,以平衡未出現病患對醫療服務單位帶來的不良影響。在本研究規劃環境中,我們將一個服務週期 (service period) 分割為數個時間區段 (slot)。病患預約要求為單一且序列性到達醫療服務單位,規劃系統將根據每個病患的未出現機率特徵,依序指派每個病患於未來某個時間區段的開始時間點作為其預約時間。同時,當一個病患已經被指派後,此病患的預約時間將不再被更改。我們的目標函式具有減少病患等待時間、降低服務週期結束時系統中等待服務人數、最大化醫院資源的使用率並同時創造最大利潤的能力。目標函式為單峰(unimode)的性質我們提供了證明。在此性質下,本研究提出之指派規劃法則將可以提供醫療服務單位對於一個服務週期中指派病患數量的準則。最後,我們測試了各種環境下,我們提出之指派規劃法則的績效表現以及敏感度分析,並針對各項參數的變化以探討對指派策略的影響。
For outpatients, efficiency of appointment scheduling is not only a important factor to guarantee the sufficient service quality, but also the criterion of client's satisfaction. However, the situation of patient no-show for pre-booked appointments wastes clinic resources, and decreases the quality of medical care. In this research, according to problems about patient no-show, a stochastic overbooking model is constructed and an appointment scheduling policy developed for outpatients with general service time. In a sequential patient call-in process, scheduler assigns patients to slots which split from a schedule horizon. As soon as an appointment is added to the schedule, it cannot be changed. An objective function published lately is used, capturing patient waiting time, staff overtime and patient revenue. The proof of unimodal property of objective evolution is provided. Finally, under a variety of conditions, the behavior of scheduling policy is investigated and compared with practical cases simultaneously.
目錄
摘要 .........................................................................................................................I
英文摘要 ............................................................................................................... II
目錄 ...................................................................................................................... III
圖目錄 .................................................................................................................. IV
表目錄 .................................................................................................................. VI
第一章 緒 論 .................................................................................................. 1
1.1研究背景 .................................................................................................. 1
1.2研究動機 .................................................................................................. 3
1.3研究目的 .................................................................................................. 5
1.4論文架構 .................................................................................................. 6
第二章 文獻探討 ............................................................................................ 7
2.1醫療指派規劃研究之分類 ...................................................................... 7
2.2靜態/動態規劃環境 ................................................................................ 8
2.3績效指標 .................................................................................................. 8
2.4系統設計 ................................................................................................ 10
2.5方法論 .................................................................................................... 11
2.6本研究之歸類 ........................................................................................ 11
第三章 預約訂位模型與指派規則 .............................................................. 13
3.1規劃環境與模型簡介 ............................................................................ 13
3.1.1病患指派規劃模型 ..................................................................... 14
3.1.2詳述指派規劃模型 ..................................................................... 16
3.2出現機率矩陣 ........................................................................................ 19
3.3溢位機率矩陣 ........................................................................................ 19
3.4聯合離開機率矩陣 ................................................................................ 24
3.5小區間長度探討 .................................................................................... 29
第四章 結果與分析 ...................................................................................... 35
4.1目標函式特徵與驗證 ............................................................................ 36
4.2演算法之績效分析及其受未出現機率之影響 .................................... 43
4.3未出現機率之集中趨勢及離散趨勢對績效的影響 ............................ 47
4.4對成本參數的敏感度分析 .................................................................... 55
第五章 結果與討論 ...................................................................................... 59
第六章 參考文獻 .......................................................................................... 60
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