顧客異質性下之醫療服務動態預約管理

隨著我國社會高齡化愈趨顯著以及醫療技術日漸精進，醫療服務需求亦隨之提高，如何在兼顧社會道德觀感及醫療品質下，適切導入需求管理方法，有效率地提升營運績效，同時提升顧客滿意度，已成為醫療服務提供者至關重要的課題之一。醫療資源有限下，醫療服務所能提供之產能時數存在其限制；而具有不同生理、病史等特性之顧客，將對系統帶來不同工作負荷，因此，有限產能下，所能負荷之顧客數量將與顧客組成有關。而各類型顧客之行為具有異質性，反映於需求、取消以及預約未到診(no-show)等行為上，為避免上述不確定性所造成之關鍵資源閒置或過度使用，進行預約機制設計時應一併列入考量。本研究同時兼顧營收、超時成本以及超時工作所導致之隱性醫療品質損失，在考量需求、取消、no-show以及服務時間變異等不確定性下，以動態規劃為基求解最佳動態預約策略。並與臺大醫院健康管理中心現況為例，分析其歷史預約資料以獲得顧客組成、需求、取消、no-show等資訊，為其求解最佳動態預約策略。並另行撰寫模擬程式，用於驗證本研究所提出之動態預約模型效度，於驗證階段，將本研究模型與另外兩對照組預約模式進行比較，分別為決策未分群之動態預約及固定預約限制等兩種預約模式。模擬結果說明本研究所提出之動態預約策略於多種參數環境下，皆明顯優於其他兩種預約方法，與決策未分群之動態預約方法相較，更說明若能適切以顧客分群方式進行預約控管，則可有效提升系統效用，避免資源閒置及超時工作。

關鍵字

醫療服務業；動態規劃；多類型需求；動態預約；營收管理

並列摘要

For performance improvement, a dynamic booking model is proposed to optimize the customer portfolio for healthcare services. In this model, the uncertainties of demand, cancellation, no-show and service time are taken into consideration, Different from the other industries, Optimization in healthcare service have to take medical quality, fairness and social moralities into account. Hence, we construct a nonlinear utility function which comprise of revenue, overtime cost and the potential loss on service quality. For estimating the utility for customer portfolios, Monte-Carlo simulation is adapted. With the nonlinear function, the objective is to maximize the expected utility. To manifest the robustness of our model, we insert our model into a real case from Healthcare Management Center (HMC) of National Taiwan University Hospital (NTUH) as a numerical study. After solving out the optimal booking policy, we construct a simulation environment to make comparison with two alternative policies: action-unclassified dynamic booking policy (UDP) and constant upper-limit booking policy (CON). In conclusion, our dynamic booking model is more robust and superior to the two alternative policies under various parameter environment.

並列關鍵字

healthcare service ； dynamic programming ； revenue management ； dynamic booking management ； multi-classes demand

參考文獻

[61] Wu, J. S., Huang, Y. H., and Chang, C. J., "Preventive Health Care in the Elderly - from Guideline to Clinical Practice," Taiwan Geriatr Gerontol, vol. 2, pp. 145-163, 2007.

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國際替代計量

顧客異質性下之醫療服務動態預約管理

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