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系統識別號 U0026-0111202010561800
論文名稱(中文) 以系統模擬探討過號看診對預約系統之影響-以骨科門診為例
論文名稱(英文) Exploring the Impact of Late Arrival Patient on the Appointment System by Using System Simulation – Taking Orthopedic Outpatient Clinic as an Example
校院名稱 成功大學
系所名稱(中) 企業管理學系
系所名稱(英) Department of Business Administration
學年度 109
學期 1
出版年 109
研究生(中文) 黃國庭
研究生(英文) Kuo-Ting Huang
學號 R46071272
學位類別 碩士
語文別 中文
論文頁數 71頁
口試委員 指導教授-黃瀞瑩
口試委員-方世杰
口試委員-李憲達
中文關鍵字 過號  等候時間  系統模擬 
英文關鍵字 Late Arrive  Waiting Time  System Simulation 
學科別分類
中文摘要 現今醫療院所大多採取預約掛號的方式,因此設計一套完善的預約系統極為重要,但是再完善的預約系統也會受病患之到診行為影響,病患會依照其過往之就診經驗與醫院建議報到時間決定其到診時間點,若是病患未依規定時間內報到而產生過號之情形,將會延長整體病患之候診時間。過長的候診時間容易使病患產生不滿的情緒、降低對醫療服務的滿意度、並提高互相傳染機會,因此醫療服務提供者需花費更多心力來應對這些感到不滿的病患,更會因為病患遲到而使醫師產能閒置。為了減緩遲到病患所帶來的影響,各醫療院所皆採取不同的過號懲罰策略,但是何種過號懲罰策略能夠在達到警示作用的同時,又能避免整體候診時間因為此策略而大幅度提升,即為本研究之探討議題。

本研究使用Arena這套軟體進行系統模擬,首先收集門診之數據,包含醫師看診平均時間、病患平均等候時間、檢查平均時間、門診流程等,接著於軟體中建立模型,分別運行三種情況( 1 )未有過號情形發生( 2 )有過號情形發生,需等待n位準時病患完成看診,才使過號病患進入叫號流程( 3 )有過號發生,需等待0-60分鐘後,過號病患才進入叫號流程,並透過模擬的方式分析其對病患等候時間之影響。

根據模擬結果,等待n位準時病患完成診療,並非最佳的方案,而使過號病患Delay 5至20分鐘再進入叫號流程,既可產生懲罰效果,亦可最小化整體病患的等候時間。本研究亦發現檢查流程占整體病患等候時間極大的比例,因此把檢查室數量增為二間,重新進行模擬,結果表明整體病患等候時間減少了將近40%,期待本研究結果能成為醫療院所評估過號策略之參考依據。
英文摘要 Nowadays, most medical institutions use appointment systems. However, even the most complete appointment system will be affected by the patient's visit behavior. Patients will decide their arrival time based on their past medical experience and the time recommended by the hospital. If the patient fails to arrive at the outpatient clinic within the specified time, it will extend the total patient's waiting time. Excessive waiting time can easily make patients feel dissatisfied, reduce their satisfaction with medical services, and increase the chance of mutual infection. In order to reduce the impact of late patients, each medical institution adopts different late arrival penalty strategies, but which strategy can achieve the warning effect while avoiding the total waiting time from being greatly affected by the strategy. That is the discussion topic of this research.

In this research, Arena software was used for system simulation. Firstly, data of outpatient clinics were collected, including the average time of doctors' consultation, average waiting time of patients, average examination time, outpatient procedures, etc. Then, models were built in the software and run in three situations (1) There is no late arrival patients (2) For patients who are late, wait for one to five punctual patients to complete their diagnosis (3) For patients who are late, wait for 0-60 minutes. At last, analyze the impact of these three conditions on patient waiting time through simulation.

According to the simulation results, waiting for N punctual patients to complete the diagnosis is not the best solution. Instead, delay 5 to 20 minutes for the late arrival patients before entering the check-in process, which can have punishment effects and minimize total patient waiting time. This research also found that the examination process accounted for a large proportion of the overall patient’s waiting time. Therefore, the number of examination rooms was increased to two and the simulation was repeated. The results showed that the overall patient waiting time was reduced by nearly 40%. It is hoped that the results of this research can become a reference for the evaluation strategy of medical institutions.
論文目次 摘要 II
誌謝 VI
目錄 VII
表目錄 IX
圖目錄 X
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 5
第三節 研究方法與流程 6
第二章 文獻回顧 8
第一節 候診時間與病患滿意度 8
第二節 減少等候時間 13
第三節 醫療系統模擬 17
第三章 研究方法 23
第一節 問題定義 24
第二節 案例門診介紹 25
第三節 模型基本假設 27
第四節 模擬模型建構 28
第四章 研究結果 30
第一節 系統模擬參數設定 30
第二節 模擬模型驗證 46
第三節 模擬結果 49
第五章 結論與未來研究方向 63
第一節 研究結論 63
第二節 研究貢獻 65
第三節 未來研究建議 66
參考文獻 67
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