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研究生:柳亦青
研究生(外文):Yi-Ching Liou
論文名稱:考量供給及需求不確定性下之醫院藥品訂購政策
論文名稱(外文):Hospital Medication Reorder Policy under Demand and Supply Uncertainties
指導教授:蔡玫亭蔡玫亭引用關係
指導教授(外文):Mei-Ting Tsai
口試委員:王建富郭佳瑋
口試日期:2017-06-22
學位類別:碩士
校院名稱:國立中興大學
系所名稱:高階經理人碩士在職專班
學門:商業及管理學門
學類:其他商業及管理學類
論文種類:學術論文
論文出版年:2017
畢業學年度:105
語文別:中文
論文頁數:52
中文關鍵詞:存貨管理藥品訂購政策需求及供應不穩定
外文關鍵詞:Inventory managementMedication reorder policy
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研究動機:藥物治療為醫療行為中不可或缺的一環,但藥品的庫存及供應過去卻常被輕忽地視為只是醫療院所日常後勤作業之一。隨著全球性的藥品短缺問題逐漸浮上檯面,供應上的不確定性可能導致醫療院所在存貨管理上的成本提高;而臨床上對藥品需求的不確定性使得管理者更加難以做出決策。本研究旨在擬定適當的藥品訂購政策,以維持適當存貨成本,並得以減少藥品缺貨問題的發生。
研究方法與設計:以五種指標(前置時間平均值、前置時間標準差、在庫數量標準差、在庫數量變化率絕對值之平均值、在庫數量變化率標準差)將藥品進行ABC分類後,運用機率模型中「需求及前置時間皆為變動」,依不同重要性擬定各藥品之再訂購點,並運用經濟訂購量模型計算每次訂購數量。最後以模擬套用藥品訂購政策半年期間每日各藥品進出狀況之在庫數量,求取存貨持有成本、訂購成本,並計算缺貨天數,驗證所擬定之藥品訂購政策是否優於現況。
資料收集與分析:本研究採用台灣中部某醫學中心為期三年之實際藥品訂購及耗用資料,並依該院所藥學部訂定之臨床不可或缺藥品共57種藥品進行探討。
研究結果:經過分析三年資料,分別依照五項指標將57種藥品進行分類,得出五種分類結果後,依照A類重要性最高、B類次之,C類重要性最低的原則擬定了藥品訂購政策。模擬各藥品訂購政策施行半年之成效,發現了同時考量了需求面及供應面不穩定性問題的「在庫數量變化率標準差」指標分類結果,成本低於現況且明顯減少了缺貨天數。
討論建議:從研究結果顯示配合五種指標所做的分類擬定之藥品訂購政策,雖無法大幅降低成本,但缺貨天數可明顯減少。妥善運用存貨管理模型可避免人為影響或只仰賴經驗判斷之可能失誤,且能更有根據性的進行存貨管理資源分配決策。
It has been decades that the issue of drug shortage affects daily practice in healthcare institutes inevitably. Every step of using alternative medication brings extra cost when any single drug shortage occurs, and the cost is difficult to estimate. In the meanwhile, acute illness patient who needs specific medication treatment often gets into any hospital in an unpredictable pattern. In order to keep the medication could be administrated timely, the hospital has to maintain a certain amount of stock. To do so, the inventory management will become a tough task for the leader of the hospital to balance the clinical need and the financial concern. This study focuses on the policy of replenishment, and intends to find some strategy to deal with the uncertainties of demand and supply.
Since it is helpful to assign different policy to different category of drugs, it would be decisive to make appropriate classification. Differ from the common way of ABC analysis which divides items by value, it would be more practical to distinguish items by importance. Five types of indicators are used in this study to do ABC analysis: 1. Mean value of lead time, 2. Standard deviation of lead time, 3. Standard deviation of inventory quantity, 4. Mean value of the changing rate calculated by daily consumption difference from the previous day, 5. Standard deviation of the changing rate. As the categories based on inventory characteristics are established, proper replenishment policy should apply to each specific category according to its characteristics. Probabilistic models considered both uncertainties of demand and supply would be useful to calculate the reorder point, and EOQ model is for the order quantity.
This study conducts an empirical example by using data from a medical center located at central Taiwan. The hospital suffered the impact of drug shortage in the last few years. Therefore, since then, the way it has managed medication inventory tends to increase the amount of storage in order to avoid any stock-out occur. However, it is not wise to lift up the stock level unlimitedly. The 57 items that the pharmacy of the hospital considered as must-have in clinical use are included in the study. To search for an effective solution, the study collects actual data of consumption and order from the period of November 2013 to October 2016.
The main objective of the study is to figure out an appropriate way to make practical classifications, and to formulate proper replenishment policies respectively. The policies should attend simultaneously to total cost of inventory and patient safety on medication treatment, hence the inventory management improved.
1. 緒論 1
1.1 研究背景 1
1.2 研究動機與目的 9
2. 文獻探討 13
2.1 存貨相關成本 13
2.2訂購模式 15
2.2.1 定期訂購 15
2.2.2 定量訂購 16
2.2.3 ABC分析 19
2.3 醫療相關存貨的訂購模式研究 20
3. 醫院藥品訂購模式之建構 24
3.1 執行ABC分類 24
3.2 藥品經濟訂購量模式 25
3.3 藥品再訂購點模式 27
4. 醫院藥品採購政策之分析 29
4.1 ABC分類結果 30
4.2 藥品經濟訂購量結果 32
4.3 藥品再訂購點結果 33
4.4 藥品訂購政策之效果分析 45
5. 結論與建議 47
參考文獻 51
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