摘要
全民健保因財務的危機實施種種管制措施，希望管制醫療服務量的成長，並且將治療病患的財務風險轉由醫療機構來承擔，因全民健保為單一保險人，醫療機構別無他法，除了不參加健保外，就只能從開源和節流來因應，因此資材存貨的管理格外重要。 在存貨管理上，成本與服務是天平的二邊，一昧的降低存貨成本或提高服務水準都不是最適化的管理。1915年Harris提出經濟訂購量(Economic Order Quantity, EOQ)模式，以總成本最小的概念決定訂購量，此理論也廣泛的應用在各產業中。許多的研究亦證實此模式可有效降低存貨成本，存貨成本降低需承擔缺貨的風險，但鮮少有研究討論對實施經濟訂購量對缺貨的影響。另外資訊業軟硬體的快速發展，改變了醫院的作業，尤其在存貨管理上資訊化與自動化大量取代人工，帳務處理的及時性大幅提昇，以往許多經濟訂購量應用上的限制也不再是問題。 在此背景下，本研究以個案研究的方式，利用模擬的概念，比較經驗法則和EOQ/ROP的定量訂購模式，這二種不同的存量管制模式在存貨平均庫存金額、週轉率、缺貨天數等管理績效上的差異。另外以問卷調查普查全國之醫學中心的存貨管理之現況，以期得到目前國內醫學中心之存貨管理概況。 研究結果發現，國內醫院之存貨管理雖比十幾年前進步，但仍不夠重視，問卷調查回覆的醫院中，有一半仍用經驗法則決定存量管制模式，不到4成的醫院有建立缺貨狀況的相關指標。 個案醫院以EOQ/ROP的模式模擬存貨水準後，藥品中央庫房之40項標的藥品之平均庫存金額下降33%，週轉次數由每月3.97次提高至5.95次，缺貨天數部分雖然從四個月內平均2.3天小幅增加到3.1天，但分析其缺貨原因主要是因為實施EOQ/ROP後，各申請部門未同步調整申請量，申請量大幅大於實際需求量的結果造成藥庫短暫的供應不繼，此亦為實務上實施EOQ/ROP模式時須特別注意的地方。
並列摘要
Because of the continued growth of medical expenditure, the Bureau of National Health Insurance has been making a series of policies to control the growth of medical expenditure. In view of limited revenue, hospitals emphasize more on cost control. In the cost structure of a hospital, materials cost is the second place. It should be the same important for inventory management in hospitals about inducing inventory cost and higher service level. Many researches have proved that EOQ (Economic Order Quantity) /ROP (ReOrder Point) model can decrease total inventory cost, but few discuss the impact on stockout. Especially after the information technology industry quickly developing, the limits of apply EOQ are no longer a big question. This research employs the approach of case-study and concept of simulation. The performance of the central medicine warehouse (include days of stockout) after implementing the EOQ/ROP model is compared with before. On the other hand, the inventory management of medical center by questionnaire survey shows half of the replied hospitals decide the inventory level with experience, only 40% monitoring the stockout. The average inventory of the 40 target items decreased 33%, and turnover times rose from 397% to 595% per month. The stockout increased due to the amount of application from customers was far from its real need. Thus, based on the results, the material management model of the study could improve the performance of the hospital material management.
參考文獻
延伸閱讀
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