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題名：同質性生產系統人員配置之效率評比模式的構建：以綜合醫療院所門診部門為例
作者：李建中 引用關係
作者(外文)：CHIEN-CHUNG LEE
校院名稱：淡江大學
系所名稱：管理科學學系
指導教授：陳淼勝
林吉吉
學位類別：博士
出版日期：2002
主題關鍵詞：決策單位；資料包絡分析法；醫療小組；人員配置效率模式；Decision Making Unit；Data Envelop Analysis；Medical Team Unit；The Efficiency Model of Employee Allocation
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論文名稱：同質性生產系統人員配置之效率評比模式的構建：以綜合醫療院所門診部門為例 頁數：95校 (院) 系組別：私立淡江大學管理科學學系畢業時間及提要別：九十學年度第二學期 博士 學位論文提要。研究生：李建中 指導教授： 陳淼勝 博士 林 吉吉 博士論文提要內容： 以服務業而言，同質性生產系統的特性是，生產系統之服務項目結構相同，但客戶之到達率呈機率分配，且客戶接受服務之過程不同之屬性，如何妥善規劃該服務體系、改善各服務項目的生產流程、進而安排各服務項目的最適人員配置，是該服務業生產系統管理上的重要課題；然屬同一同質性生產系統各DMU間，即存在許多先天環境上本質的差異，以綜合醫療院所為例，各綜合醫療院所間成立之宗旨、服務對象、規模大小、地理位置等各有不同，醫院內部管理上之績效評估便會有所差異，而不同型式的績效衡量方法將導致不同績效結果，故建立一能排除各DMU間先天環境上本質的差異，僅就各決策主管可控制部份負責之績效衡量方法，是本研究主要目的。綜合醫療院所門診部門的服務體系具有同質性生產系統之特徵，且其具有非營利之特性，故本研究以綜合醫療院所門診部門為例，期望建立更適合綜合醫療院所之績效衡量方法。醫療管理的問題可分醫院個體內部管理與整體醫療資源規劃兩大類，其中醫院個體診療服務過程的特徵是：病患依不同病別在各醫療服務項目間移轉、單位時間內到達任何醫療項目之人數、單一病患接受診療的期望時間、以及單位時間內由任何醫療項目離開醫院的人數，均是隨機發生的；此隨機過程屬性的行政組織體系之管理服務績效相關的問題，是現今綜合醫療院所內部管理議題上，不容忽視的一環。而本研究所指的行政管理服務績效，乃泛指在組織程序構面中可被標準化之行政部份的服務績效而言。本研究以服務水準為目標函數，診療服務過程的人力資源為投入變數，構建出綜合醫療院所的人員配置效率函數(EMEA)，並提出有別於DEA衡量法的異同點；本研究同時提出相對服務效率衡量指標S，來做為綜合醫療院所間的比較基礎，以排除個別綜合醫療院所間先天上的差異(如病患到達率及組織規模等)來比較。而政府醫療政策主管單位並可以此為比較基礎，來做為醫療資源的分配的依據。此指標可達成醫療資源的合理分布之醫療體制。另外以效率函數之特性為基礎，加上各醫療項目之單位醫療小組成本，構建綜合醫療院所的成本函數，分為醫療小組作業工時成本函數模式(HCF Model)與醫療小組單位數成本函數模式(NCF Model)，並分別求解，模式解法與針對參數變動下之敏感性分析分別在本章被提出。本章嘗試找出一建議的醫療小組投入使得該綜合醫療院所之需之成本達最小化。 最後再於成本函數中加入收入因素，政府的補助函數、醫療院所的單位病患收入、及綜合醫療院所的固定成本等因素，將成本函數延伸以構建綜合醫療院所的利潤函數，其中，政府的補助函數是本研究醫院個體管理與整體醫療政策掛勾的媒介，模式部份亦分為醫療小組作業工時利潤函數模式(HPF Model)與醫療小組單位數利潤函數模式(NPF Model)，並分別求解之。本研究嘗試找出一建議的服務績效水準及該水準下之最適醫療小組之投入使得該綜合醫療院所之利潤達最大化。
Title of Thesis: Modeling for Service Efficiency of Human Resource Allocation in Homogeneous Production System: Taking The Department of Outpatient Service for General Hospital as Example total pages: 95
Key words: Decision Making Unit, Data Envelop Analysis, Diagnosis Related Group, General Cost Function, .Hours for Profit Function, Hours for Cost Function, Medical Team Unit, Number for Cost Function, Number for Profit Function, The Efficiency Model of Employee allocation
Name of Department: Department of Management Sciences,
Tamkang University
Graduation Date: June 2002 Degree Conferred: Ph.D.
Name of Student: Chien-Chung Lee Advisors: Dr. Miao-Sheng Chen
李 建 中 陳淼勝 博士
Dr. Che Lin
林 吉吉 博士
Abstract：
The medical care problem can be divided into two categories: interior management and medical resource planning. It is the character of the general hospital that the following items are stochastic: the patient transfer between health care items according to different diseases, the arrival to any health care item per unit time, and the number of the patients leaving the general hospital from a health care item. In this article, a research is constructed to face the administration service quality problem in an administration organization system with a random process. In fact, this study focuses on the administration service quality that can be standardized in the general hospital.
In this research constructs the production function; its input variable is the service capacity (human resources of each health care item) and the output variable is the relative service efficiency of the general hospital. The measurement indicator S (relative service efficiency) is developed to be the comparison basis, and the differences between DEA and S are discussed in the research either. The measurement method proposed in this work can reduce the influence of the hospital size and the different patient arrival rate for the general hospital. In addition, the government can use it as the basis of medical resource distribution. This method leads to be the fairer method for medical resource distribution.
There are two cost function models proposed in the Chapter 4; they are the cost function model with considering MTU (Medical Team Unit) working hours input (HCF Model) and the cost function model with considering the number of MTU input (NCF Model). In addition, the heuristic methods dealing with these two models for searching their solution are made; the sensitivity analyses for the solution with the key factors are also provided. Moreover, the numerical examples are also prepared. This chapter does reveal that the input of MTU leads to minimize the cost with considering the given relative service efficiency.
The subsidiary function of the government, the average fixed contribution of a patient, and the fixture cost of the general hospital are considered into this chapter to construct two profit function models; they are the profit function model with considering MTU working hours input (HPF Model) and the profit function model with considering the number of MTU input (NPF Model). In addition, the methods dealing with these two models for searching the solution are developed, the decision criteria for determining the solution, and the numerical examples are also prepared. This chapter tends to search the suggested service level leads to maximize the total profits with considering the MTU allocation.
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