智能藥櫃導入之資本化決策—以癌症醫院為例

Capitalization Decision for the introduction of Automated Dispensing Cabinet — A Case Study on Cancer Center

許派洲(Pai-Chou Hsu)

指導教授 ： 李書行

國立臺灣大學/管理學院/會計與管理決策組/碩士(2020年)

https://doi.org/10.6342/NTU202002770

摘要

病人的用藥安全對藥師而言是則無旁貸的。但近年來藥師人力缺乏，讓以人為主調劑工作非常吃力。必須引進新的方法來取代人力調劑，才是長久解決之道。這是為什麼要引進智能藥櫃。但使用智能藥櫃對營運並不會產生正向金流，但品質提升帶來的價值能否超越機器的購置成本，都將會是這個模式值得探討的方向。研究目的如下:
本次研究的目的是希望能夠證明，智能藥櫃的使用不但能減少藥師的工作，也能達到投資平衡。個案醫院從處方覆蓋量、退藥量與錯誤率的變化，來評估在全院病房使用智能藥櫃的資本回饋。
研究範圍僅納入使用頻次為立即使用及需要時服用的醫令。所以在此使用條件下收集2020年3月至5月關於處方覆蓋量、退藥量與錯誤率的數字，並將退藥率與錯誤率與上線前的數字進行比較。
本研究得到以下的結果與結論
1. 處方覆蓋量平均每月為 8,480 筆，預估節省費用 976,896 元。
2. 退藥量平均每月減少9,988筆，預估節省費用1,024,769元。
3. 錯誤率下降0.00106%，預估節省費用8,178元。
4. 結論：投資回收年限21年又6個月。
本研究有下四個建議
1. 持續擴大醫令覆蓋量
2. 錯誤率下降雖然有限，但仍應持續努力避免犯錯。
3. 拓展智能藥櫃往新的使用方向發展
4. 致力改變藥師工作性質

關鍵字

智能藥櫃 ； 退藥 ； 調配錯誤率 ； 資本化決策 ； 癌症醫院

並列摘要

The safety of the patient's medication is undeniable to pharmacists. However, the lack of manpower in pharmacists in recent years has made it very difficult for people to take the main prescription. New methods must be introduced to replace manpower adjustment, which is the long-term solution. This is why automated dispensing cabinets are introduced. However, the use of automated dispensing cabinets will not generate a positive cash flow for operations, but whether the value of quality improvement can exceed the purchase cost of the machine will be the direction of this model worth exploring. The research objectives are as follows:
The purpose of this study is to prove that the use of automated dispensing cabinets can not only reduce the work of pharmacists, but also achieve a balanced investment. The case hospital evaluates the capital feedback for the use of automated dispensing cabinets in the wards of the entire hospital from the changes in prescription coverage, returned drugs, and error rates.
The scope of the study only included medical orders that were used immediately and when as needed. So under these conditions of use, collect the numbers of prescription coverage, drug returned and error rate from March to May 2020, and compare the drug returned and error rate with the numbers before going online.
This study obtained the following results and conclusion
1. The average amount of prescription coverage is 8,480 per month, and the estimated cost savings are NTD 976,896.
2. The amount of returned drugs decreased by an average of 9,988 per month, with an estimated cost savings of NTD 1,024,769 .
3. The error rate reduce by 0.00106%, and the estimated cost savings are NTD 8,178.
4. Conclusion: The investment recovery period is 21 years and 6 months.
There are four recommendations for this study
1. Continue to expand the coverage of medical orders.
2. Although the decline in error rate is limited, continuous efforts should be made to avoid making mistakes.
3. Expand the development of automated dispensing cabinets in new directions.
4. Committed to changing the nature of pharmacist's work.

並列關鍵字

Automated dispensing cabinet ； Returned drug ； Dispensing error rate ； Capitalization Decision ； Cancer center

參考文獻

一、中文部份

衛生福利部統計處，衛生類公務統計，醫事機構與醫事人員統計，醫事人員發證人數，https://dep.mohw.gov.tw/DOS/lp-1728-113.html, 搜尋日期：2020年06月10日

行政院性別平等會，重要性別統計資料庫，國內指標，醫院平均住院日數，取自：https://www.gender.ey.gov.tw/gecdb/Stat_Statistics_DetailData.aspx?sn=P9FjL3GCbF7yB3lDgZAomQ%3D%3D d=194q2o4%2BotzoYO%2B8OAMYew%3D%3D, 搜尋日期：2020年06月10日

衛生福利部醫事司，醫療財團法人管理相關業務，04醫療財團法人財務報告，4-1醫療財團法人歷年財務報表，取自：https://dep.mohw.gov.tw/DOMA/cp-3175-15984-106.html, 搜尋日期：2020年06月10日

楊嘉玲. 2011. 國際醫療趨勢下護理人員加強英語溝通能力之必要性，護理雜誌 58卷1期：97-100