門診叫號排程系統設計──從階層線性模型預測服務時間角度切入

在醫院長時間的候診行為對醫院來說是一種營運上的成本，除了影響病患對醫療體系的滿意度外，同時也會增加醫護人員超時工作情況及醫療空間運用的不效率。即便目前醫院引進叫號系統能夠告知病患建議候診時間，此種叫號系統卻只能以服務時間平均數估算病患看診時間，用以推斷相應序號病患應等待的時間。但是看診服務時間是一種變異很大的參考數值，這往往導致病患所獲得的資訊不準確，致使病患過號可能性增加，也會導致病患對叫號系統的不信任，反而花更多時間在候診間候診。因此，本研究欲設計一種新型的叫號排程系統，讓病患可以選擇自己想要看診的時段，並透過分析真實樣本資料，以階層線性模式預測病患服務時間之基礎，進一步進行排程，並用模擬分析驗證。　　進行模擬分析後，實證結果顯示，透過新型排程系統將有效增加醫院營運六項指標之效益，其指標包含病患候診時間、醫師閒置時間、醫師超時工作、醫師看診人數、候診間人數以及長時間候診率。以階層線性模型預測病患候診時間，並須同時考量樣本資料的偏差值，才能夠掌握服務時間的變異。而排程在以 30 分鐘為一個時段的排程方法下，時段內平均安排 7~8 人將能夠使六項指標的效益達到最高。

關鍵字

門診排程；階層線性模型；模擬分析；時間預測；醫療流程優化

並列摘要

Hospitals have been faced with the problem of patients’ waiting time in outpatient which impact the operational efficiency of hospitals. Long waiting time not only worsens the patient’s satisfaction toward the healthcare system, but also raises the possibility of overtime for healthcare workers and inefficiency in using outpatient spaces. The number systems currently implemented in hospitals provide the expected waiting time to patients. However, the predictions are calculated based on the mean of the service time only, ignoring the huge variation between patients. This leads to more crossing numbers and doctor idling time. Finally, it turns out to be patients distrusting the system and spending more time waiting in the hospital. 　　To solve this problem, a new scheduling system is designed in this thesis. By assuming patients’ preference of arrival time, the system first predicts the patients’ service time based on the real data of a single outpatient clinic by using hierarchy linear model (HLM). Then, based on the preference, schedules the patients’ appointment. The system would be tested with simulation and six key operation indexes would be observed: average waiting time of patients, average idling time of the doctor, average number of overtime, average number of patient serviced without using overtime workforce, average number of waiting patients in outpatient, and probability of long time waiting. The result shows placing 7-8 patients in a slot of 30 minutes uniformly would make a significant improvement in the six key indexes. The prediction model built in the system shows a better MAPE comparing to the system of using mean, which means the service time would be influenced by patients’ heterogeneity.

並列關鍵字

Appointment scheduling ； Hierarchy linear model ； Simulation ； Time prediction ； Healthcare reformulation

參考文獻

中文參考文獻

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英文參考文獻

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門診叫號排程系統設計──從階層線性模型預測服務時間角度切入

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