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研究生:邱志豪
研究生(外文):CHIU, CHIH-HAO
論文名稱:建構具模糊數學之系統動態學於台灣醫護人力預測
論文名稱(外文):Constructing a Dynamic System with Fuzzy Arithmetic for Physician and Nursing Manpower Prediction in Taiwan
指導教授:張炳騰張炳騰引用關係洪國禎洪國禎引用關係
指導教授(外文):CHANG, PING-TENGHUNG, KUO-CHEN
口試委員:張炳騰洪國禎時序時白炳豐
口試委員(外文):CHANG, PING-TENGHUNG, KUO-CHENSHIH, HSU-SHIHPAI, PINR-FENG
口試日期:2017-06-14
學位類別:碩士
校院名稱:東海大學
系所名稱:工業工程與經營資訊學系
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:2017
畢業學年度:105
語文別:中文
論文頁數:47
中文關鍵詞:預測癌症病患醫護人力系統動態學模糊理論
外文關鍵詞:PredictionCancer CarePhysician and Nursing ManpowerSystem DynamicsFuzzy Theory
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本研究採用系統動態學方法預測未來10年台灣癌症醫護人力需求,根據門診及住院的資料型態下建立癌症醫護人力需求系統動態模型,而在現實環境中存在著許多的不確定因子,若將系統動態學各因子以明確值方式進行模擬預測,對於現實環境而言較無法被接受;因此,為解決不確定性因子所帶來之影響,本研究在不同資料庫所取得之資料轉換過程中將明確值以模糊形式進行運算,以減少資料轉換過程中重要資訊的流失,並使模擬結果更貼近於現實環境。
本研究模擬結果顯示,模糊系統動態模式之預測能力(MAPE)略優於傳統系統動態模式,為使模擬結果較貼合現實環境因此本研究採用模糊系統動態模式進行後相關分析及預測;在模擬趨勢圖中可以看出,未來10年癌症醫護人力需求將會持續不斷增加,且趨勢尚未有趨於平緩的情況;另外,將模糊系統動態模式所預測之結果進行解模糊,將解模糊之結果作為癌症醫護人力之需求面,另將過去10年醫護人力統計資料,計算趨勢及癌症醫護人力比例預測未來10年癌症醫護人力之供給情況作為供給面,結果顯示因需求量成長速度遠大於供給量成長速度,因此供需兩者之間的差距將會越來越大;在2027年時,癌症住院醫師人力不足7083人、護理師不足26297人,在癌症門診醫師人力不足1613人、護理師不足4967人。
In this study, the system dynamics is used to predict the demand of physicians and nursing manpower for cancer care in Taiwan for the next 10 years. The study constructs the system dynamics model with outpatient and inpatient data types. Yet, there are many uncertain factors. Using crisp value for these factors for prediction may not be acceptable in the real world. Therefore, in order to resolve the impact of uncertain factors, and to reduce the loss of important information in the data conversion process, this study uses fuzzy logic as the computing mechanism for the crisp value during the data conversion process from the different databases, to make the simulation results closer to the real world.
The result shows that the MAPE in fuzzy system dynamics model is better than the MAPE in crisp system dynamics model. Thus, in order to make the simulation results more suitable for the real world, this study adopts the fuzzy system dynamic model for further analysis and prediction. The result shows that the needs of physicians and nursing manpower for cancer care will continue to increase, and this trend will not turn to a mild situation in the next 10 years. Using the result after defuzzification of the fuzzy system dynamics prediction as the demand for physicians and nursing manpower, also using the health care manpower data in the past 10 years and calculating the growth rate, with the growth rate to predict the manpower of physicians and nursing for cancer care as the supply, the result shows that the growth rate of the demand is much faster than the growth rate of the supply. The situation of shortage will be worse. In 2027, the shortage in physicians for cancer inpatients is 7083 and nurses is 26297, and the shortage for outpatients in physicians is 1613 and nurses is 4967.

摘 要..............I
ABSTRACT...............II
致謝詞.................III
目錄...................IV
表目錄..................V
圖目錄..................VI
第一章 緒論..............1
1.1 研究背景動機.........1
1.2 研究目的............2
1.3 研究架構............3
第二章 文獻探討..........5
2.1 目前相關研究.........5
2.2 系統動態學...........7
2.3 模糊運算.............9
第三章 研究方法...........13
3.1 資料收集.............13
3.2 資料處理.............15
3.3 系統動態模型建構......16
3.4 模式參數設定..........17
第四章 模型建構與結果分析..20
4.1 癌症門診醫護人力模型..20
4.2 癌症住院醫護人力模型..27
4.3 分析與討論...........35
第五章 結論與建議.........41
5.1 研究總結.............41
5.2 未來研究方向.........42
參考文獻.................44


中文部分
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3.李選、白香菊與顏文娟(2008)。台灣地區護理人員執業環境之現況調查。護理雜誌,55(4),30-52。
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1. 1. 何明宗(2008)。臺灣地區未來醫師人力供需研究-灰色預測模式之應用。醫務管理期刊,9(4),255-270。
2. 2. 何明宗、王智弘與林曜祥(2007)。臺灣地區耳鼻喉科醫師人力供需之研究。臺灣耳鼻喉頭頸外科雜誌,42(2),43-50。
3. 3. 李選、白香菊與顏文娟(2008)。台灣地區護理人員執業環境之現況調查。護理雜誌,55(4),30-52。
4. 4. 李選、張婷(2012)。台灣護理專業對教考用失衡議題之省思。護理雜誌,59(5),16-23。
5. 5. 邱淑芬、蔡欣玲(1996)。德爾菲預測術-一種專家預測的護理研究方法。護理研究,4(1),92-98。
6. 6. 林佳靜、曾翠華、蕭淑貞、王淑怡、盧美秀與鍾聿琳(2008)。臺灣護理教育專業人才培育的現況。醫護科技學刊,10(3),145-158。
7. 7. 林秋芬、高靖秋(2014)。臨床護理人力運用的演變與前瞻。護理雜誌,61(2),13-19。
8. 8. 林哲瑩(2015)。建構居家服務之照顧服務員的人力需求評估模式。社會發展研究學刊,(16),67-94。
9. 9. 周守民(2012)。台灣護理教育對護士荒時代之因應。護理雜誌,59(5),24-29。
10. 10. 周春美、沈健華(2004)。商專人力供需預測及業界需求之分析。教育學刊,(22),177-198。
11. 11. 高靖秋(2011)。台灣護理人力面面觀。澄清醫護管理雜誌,7(3),41-46。
12. 12. 徐健進(2012)。國際法政產業人力之預測模型研究。蘭陽學報,11,48-58。
13. 14. 陳姵汝、呂宛庭、陳映儒、沈雅雯與簡佑任(2015)。護理人員就業福利之探討。健康與建築雜誌,2(1),10-15。
14. 15. 張元玫、李秋霞(2014)。急診室護理人力需求探討。健康與建築雜誌,1(4),75-80。
15. 16. 張媚、余玉眉、陳月枝與田聖芳(2005)。台灣護理人力規劃研究。臺灣醫學,9(2),149-156。
 
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