工业工程在台湾医院管理之研究与应用
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摘要
台湾有两万余家医疗机构,呈多元化发展格局,医疗服务水平逐年提升。自1995年台湾实施全民健保政策之后,医院管理面临更高的要求和运营的挑战。因此,本文介绍了台湾的医院概况,并给出相应的大陆医院相关数据;探讨工业工程技术在台湾医院管理不同方面的研究与应用,工业工程技术能够使医院在有限的医疗资源条件下发挥最大化的绩效;结论认为系统、深入地应用工业工程技术将有效提升医院管理的水平。
In Taiwan,there are over 20 thousand medical institutions with great diversity in development.The medical service quality has improved steadily in recent years.Since National Health Insurance was put into effect in Taiwan in 1995,there were more challenges in hospital management.In this paper,the general Taiwan hospital information is introduced while the Mainland related data is listed.Also,various researches and applications of industrial engineering technology to Taiwan hospital management are introduced.It shows that industrial engineering technology used in hospitals with limited medical resources can bring forth the best performance.The conclusion shows that hospital management performance will be improved significantly by systematical application of industrial engineering technology.
In Taiwan,there are over 20 thousand medical institutions with great diversity in development.The medical service quality has improved steadily in recent years.Since National Health Insurance was put into effect in Taiwan in 1995,there were more challenges in hospital management.In this paper,the general Taiwan hospital information is introduced while the Mainland related data is listed.Also,various researches and applications of industrial engineering technology to Taiwan hospital management are introduced.It shows that industrial engineering technology used in hospitals with limited medical resources can bring forth the best performance.The conclusion shows that hospital management performance will be improved significantly by systematical application of industrial engineering technology.
引文
[1]“行政院卫生署”.医疗机构现况及医院医疗服务量统计年报[R].台湾:“行政院卫生署”,2011.
[2]《中国卫生年鉴》编辑委员会.中国卫生年鉴2001[M].北京:人民卫生出版社,2001.
[3]中华人民共和国卫生部.2011中国卫生统计年鉴[M].北京:中国协和医科大学出版社,2011.
[4]财团法人医院评鉴暨医疗品质促进会网站.医院评鉴及教学医院评鉴简介[R/OL].(2012-07-29).http:∥www.tjcha.org.tw/FrontStage/page.aspx?ID=088AB6C2-1B58-42F4-9E27-6597273D5ECF.
[5]“行政院卫生署”中央健康保险局网站.2011-2012全民健康保险简介[R/OL].(2012-07-29).http:∥www.nhi.gov.tw/Resource/webdata/20782_1_2011-2012健保简介.pdf
[6]中央人民政府网站.关于印发《台湾服务提供者在大陆设立独资医院管理暂行办法》的通知[R/OL].(2010-10-22).http:∥www.gov.cn/gzdt/2010-12/29/content_1775497.htm.
[7]Gilbreth F B,Providence R I.Hospital efficiency from thestandpoint of the efficiency expert[J].Boston Medical andSurgical Journal,1915(21):774-775.
[8]Gilbreth F B,Providence R I.Motion study in surgery[J].The Canadian Journal of Medicine and Surgery,1916,40(1):22-31.
[9]Gilbreth F B.Scientific management in the hospital[J].TheModern Hospital,1914(3):321-324.
[10]张锦文,谭开元,黄佳经.医院管理[M].台北:水牛图书出版事业有限公司,1991.
[11]江志斌,储斌,张国通,等.工业工程在医院信息系统中的应用[J].中国医院管理,2005,25(7):30-32.Jiang Zhi-bin,Chu Bin,Zhang Guo-tong,et al.Applica-tions of industrial engineering in hospital information sys-tems[J].Chinese Hospital Management,2005,25(7):30-32.
[12]简祯富,郭仁村.工业工程在台湾产业界的典范移转[J].工业工程,2011,14(4):1-10.Chien Chen-fu,Kuo Ren-tsun.The shifting paradigm of in-dustrial engineering in taiwan[J].Industrial EngineeringJournal,2011,14(4):1-10.
[13]黄怡诏,简祯富,刘志明,等.建构网际网路环境下之医院主管资讯系统及其实证研究[J].工业工程学刊,2004,21(2):101-112.Huang Yi-chao,Chien Chen-fu,Liu Chih-ming,et al.Con-structing web-based hospital executive Information systemand an empirical study[J].Journal of the Chinese Instituteof Industrial Engineers,2004,21(2):101-112.
[14]张伟斌,林怡卿,刘德明.台北市立联合医院构建医院主管资讯系统之经验[J].北市医学杂志,2006,3(12):87-96.Chang Wei-pin,Lin Yi-ching,Liu Der-ming.Experiencesof implementation of the hospitao executive information sys-tem in taipei city hospital[J].Taipei City Medical Journal,2006,3(12):87-96.
[15]Graban Mark.精益医院:世界最佳医院管理实践[M].北京:机械工业出版社,2011.
[16]简祯富,胡志翰.全面资源管理架构:以晶圆厂为实证[J].品质学报,2011,18(6):581-607.Chien Chen-fu,Hu Chih-han.Total resource managementframework:an empirical study of semiconductor fab[J].Journal of Quality,2011,18(6):581-607.
[17]张力平.医学中心营运竞争力指标群建立之研究[D].台湾:台湾大学,2004.Chang Li-ping.Building a comprehesive competitivenessindicators set for medical center category hospital[D].Tai-wan:National Taiwan University,2004.
[18]郭家良.层级分析法在医院管理之应用[D].台湾:东吴大学,2007.Kuo Chia-liang.The application of AHP on hospital man-agement[D].Taiwan:Soochow University,2007.
[19]朱文洋,叶淑娟.中小型医院经营策略与营运绩效之探讨——以平衡记分卡观点分析[J].医务管理期刊,2001,2(2):109-138.Chu Wen-yang,Yeh Shu-chuan.Strategic managementandhospital performances in small medium hospitals-fromthe viewpoint of balanced scorecard[J].Journal of Health-care Management,2001,2(2):109-138.
[20]马启康.多属性之层级收益规划[D].台湾:台湾大学,2010.Ma Chi-kang.Multi-attribute hierarchical revenue planning[D].Taiwan:National Taiwan University,2010.
[21]吕俊德,黄郁琮,陈秀赀.ARIS流程管理方法在医疗作业流程之应用:以某区域医院为例[J].医务管理期刊,2007,8(2):172-193.LüJun-der,Huang Yu-tsung,Chen Shiu-tzu.Application ofARIS methodology to the clinical processes:a case study ofregional hospital[J].Journal of Healthcare Management,2007,8(2):172-193.
[22]黄凯琳,苏维文,孙茂胜,等.肝癌患者经导管动脉化学栓赛治疗标准流程之建立及其效益评估[J].台湾公共卫生杂志,2005,24(4):284-295.Hwang Kai-lin,Su Wei-wen,Soon Maw-soan,et al.Evalu-ation of the implementation of clinical guidelines for tran-scatheter arterial chemo-embolization of patients with hepa-tocellular carcinoma[J].Taiwan Journal of Public Health,2005,24(4):284-295.
[23]李佳静,庄慧瑛,刘耿彰.医疗器材:如何促进病人安全[J].慈济医学杂志,2007,19(1s):49-53.
[24]傅柏翔.医院病例室工作人员肌肉骨骼不适之评估—以南部某教学医院为例[D].台湾:高雄医学大学,2010.Fu Bai-xiang.An evaluation of medical records staffs’mus-culoskeletal disorder[D].Taiwan:Kaohsiung Medical Uni-versity,2010.
[25]廖茂宏,杨红玉,张威国,等.以平衡记分卡基础发展医院人力资源管理指标[J].健康管理学刊,2005,3(2):189-203.Liao Mao-hung,Yeung Hung-yuk,Chang Wei-kuo,et al.Developing human resource management indicators of hospi-tals-based on balanced scored card[J].Journal of HealthManagement,2005,3(2):189-203.
[26]Chien Chen-Fu,Tseng F,Chen C.An evolutionary ap-proach to rehabilitation patient scheduling:a case study[J].European Journal of Operational Research,2008,189(3):1234-1253.
[27]孙文忠.全面品质管理在医院病例管理之应用研究[D].台湾:中华工学院,1997.Sun Wen-chung.Application and research of total qualitymanagement to the hospital medical record management[J].Taiwan:Chung Hua Polytechnic Institute,1997.
[28]卢安琪.国立成功大学医学中心门诊医疗服务品质之实证研究[D].台湾:国立成功大学,2002.Lu An-qi.An empirical study on outpatient service qualityof national cheng kung university[D].Taiwan:NationalCheng Kung University,2002.
[29]Parasuraman A,Zeithaml V A,Berry L L.A conceptualmodel of service quality and its implication for future re-search.[J].Journal of Marketing,1985,49(Fall):41-50.
[30]汤淑贞,黄佳经,廖茂宏,等.物流委外模式导入对医院资材库存管理成效研究及满意度调查[J].医务管理期刊,2004,5(4):438-459.Tang Shu-chen,Hung Chia-ching,Liao Mao-hung,et al.The effectiveness and satisfactory study of introducing out-sourcing distribution operation for hospital inventory man-agement-take one specific hospital as an example[J].Jour-nal of Healthcare Management,2004,5(4):438-459.
[31]黄怡诏,陈郁夫,简祯富.新竹科学园区药品网路订购系统之建置与实证研究[J].医疗资讯杂志,2004,13(2):35-46.Huang Yi-chao,Chen Yuh-fu,Chien Chen-fu.Construc-ting the network medicine order systemfor hsinchu sciencepark and an empirical study[J].The Journal of Taiwan As-sociation for Medical Informatics,2004,13(2):35-46.
[32]张月霞,林倖安,庄芬绮,等.提升手术室器械管理成效之改善专案[J].护理杂志,2010,57(2):70-78.Chang Yu-hsia,Lin Shing-an,Juang Fen-chii,et al.Pro-ject to improve operating room surgical apparatus manage-ment[J].The Journal of Nursing,2010,57(2):70-78.
[33]台大医院医疗体系简介.台大医院网站[R/OL].(2012-07-29).http:∥www.ntuh.gov.tw/About_Us/aboutNTUH/%e9%ab%94%e7%b3%bb%e7%b0%a1%e4%bb%8b.aspx.
[34]周雍强,吴政鸿,陈正刚,等.快乐医疗—工业工程的服务应用[R].科学委员会补助专题研究计划,2010-2013.
[35]陈贻善.台北长庚医院的成功管理模式—医院管理与绩效评估[J].国际医药卫生导报,2001(6):9-10.
[36]吴振隆.工业工程在医疗产业管理之应用[R/OL].(2001-04-18).http:∥bbs.cenet.org.cn/uploadimages/2003112817402473839.pdf
[37]医院现况.马偕纪念医院网站[R/OL].(2012-07-29).http:∥www.mmh.org.tw/intro/intro6.asp.
[38]系所沿革.东海大学工业工程与经营资讯学系网站[R/OL].[2012-07-29].http:∥www.ie.thu.edu.tw/in-tro/pages.php?ID=intro3.
[2]《中国卫生年鉴》编辑委员会.中国卫生年鉴2001[M].北京:人民卫生出版社,2001.
[3]中华人民共和国卫生部.2011中国卫生统计年鉴[M].北京:中国协和医科大学出版社,2011.
[4]财团法人医院评鉴暨医疗品质促进会网站.医院评鉴及教学医院评鉴简介[R/OL].(2012-07-29).http:∥www.tjcha.org.tw/FrontStage/page.aspx?ID=088AB6C2-1B58-42F4-9E27-6597273D5ECF.
[5]“行政院卫生署”中央健康保险局网站.2011-2012全民健康保险简介[R/OL].(2012-07-29).http:∥www.nhi.gov.tw/Resource/webdata/20782_1_2011-2012健保简介.pdf
[6]中央人民政府网站.关于印发《台湾服务提供者在大陆设立独资医院管理暂行办法》的通知[R/OL].(2010-10-22).http:∥www.gov.cn/gzdt/2010-12/29/content_1775497.htm.
[7]Gilbreth F B,Providence R I.Hospital efficiency from thestandpoint of the efficiency expert[J].Boston Medical andSurgical Journal,1915(21):774-775.
[8]Gilbreth F B,Providence R I.Motion study in surgery[J].The Canadian Journal of Medicine and Surgery,1916,40(1):22-31.
[9]Gilbreth F B.Scientific management in the hospital[J].TheModern Hospital,1914(3):321-324.
[10]张锦文,谭开元,黄佳经.医院管理[M].台北:水牛图书出版事业有限公司,1991.
[11]江志斌,储斌,张国通,等.工业工程在医院信息系统中的应用[J].中国医院管理,2005,25(7):30-32.Jiang Zhi-bin,Chu Bin,Zhang Guo-tong,et al.Applica-tions of industrial engineering in hospital information sys-tems[J].Chinese Hospital Management,2005,25(7):30-32.
[12]简祯富,郭仁村.工业工程在台湾产业界的典范移转[J].工业工程,2011,14(4):1-10.Chien Chen-fu,Kuo Ren-tsun.The shifting paradigm of in-dustrial engineering in taiwan[J].Industrial EngineeringJournal,2011,14(4):1-10.
[13]黄怡诏,简祯富,刘志明,等.建构网际网路环境下之医院主管资讯系统及其实证研究[J].工业工程学刊,2004,21(2):101-112.Huang Yi-chao,Chien Chen-fu,Liu Chih-ming,et al.Con-structing web-based hospital executive Information systemand an empirical study[J].Journal of the Chinese Instituteof Industrial Engineers,2004,21(2):101-112.
[14]张伟斌,林怡卿,刘德明.台北市立联合医院构建医院主管资讯系统之经验[J].北市医学杂志,2006,3(12):87-96.Chang Wei-pin,Lin Yi-ching,Liu Der-ming.Experiencesof implementation of the hospitao executive information sys-tem in taipei city hospital[J].Taipei City Medical Journal,2006,3(12):87-96.
[15]Graban Mark.精益医院:世界最佳医院管理实践[M].北京:机械工业出版社,2011.
[16]简祯富,胡志翰.全面资源管理架构:以晶圆厂为实证[J].品质学报,2011,18(6):581-607.Chien Chen-fu,Hu Chih-han.Total resource managementframework:an empirical study of semiconductor fab[J].Journal of Quality,2011,18(6):581-607.
[17]张力平.医学中心营运竞争力指标群建立之研究[D].台湾:台湾大学,2004.Chang Li-ping.Building a comprehesive competitivenessindicators set for medical center category hospital[D].Tai-wan:National Taiwan University,2004.
[18]郭家良.层级分析法在医院管理之应用[D].台湾:东吴大学,2007.Kuo Chia-liang.The application of AHP on hospital man-agement[D].Taiwan:Soochow University,2007.
[19]朱文洋,叶淑娟.中小型医院经营策略与营运绩效之探讨——以平衡记分卡观点分析[J].医务管理期刊,2001,2(2):109-138.Chu Wen-yang,Yeh Shu-chuan.Strategic managementandhospital performances in small medium hospitals-fromthe viewpoint of balanced scorecard[J].Journal of Health-care Management,2001,2(2):109-138.
[20]马启康.多属性之层级收益规划[D].台湾:台湾大学,2010.Ma Chi-kang.Multi-attribute hierarchical revenue planning[D].Taiwan:National Taiwan University,2010.
[21]吕俊德,黄郁琮,陈秀赀.ARIS流程管理方法在医疗作业流程之应用:以某区域医院为例[J].医务管理期刊,2007,8(2):172-193.LüJun-der,Huang Yu-tsung,Chen Shiu-tzu.Application ofARIS methodology to the clinical processes:a case study ofregional hospital[J].Journal of Healthcare Management,2007,8(2):172-193.
[22]黄凯琳,苏维文,孙茂胜,等.肝癌患者经导管动脉化学栓赛治疗标准流程之建立及其效益评估[J].台湾公共卫生杂志,2005,24(4):284-295.Hwang Kai-lin,Su Wei-wen,Soon Maw-soan,et al.Evalu-ation of the implementation of clinical guidelines for tran-scatheter arterial chemo-embolization of patients with hepa-tocellular carcinoma[J].Taiwan Journal of Public Health,2005,24(4):284-295.
[23]李佳静,庄慧瑛,刘耿彰.医疗器材:如何促进病人安全[J].慈济医学杂志,2007,19(1s):49-53.
[24]傅柏翔.医院病例室工作人员肌肉骨骼不适之评估—以南部某教学医院为例[D].台湾:高雄医学大学,2010.Fu Bai-xiang.An evaluation of medical records staffs’mus-culoskeletal disorder[D].Taiwan:Kaohsiung Medical Uni-versity,2010.
[25]廖茂宏,杨红玉,张威国,等.以平衡记分卡基础发展医院人力资源管理指标[J].健康管理学刊,2005,3(2):189-203.Liao Mao-hung,Yeung Hung-yuk,Chang Wei-kuo,et al.Developing human resource management indicators of hospi-tals-based on balanced scored card[J].Journal of HealthManagement,2005,3(2):189-203.
[26]Chien Chen-Fu,Tseng F,Chen C.An evolutionary ap-proach to rehabilitation patient scheduling:a case study[J].European Journal of Operational Research,2008,189(3):1234-1253.
[27]孙文忠.全面品质管理在医院病例管理之应用研究[D].台湾:中华工学院,1997.Sun Wen-chung.Application and research of total qualitymanagement to the hospital medical record management[J].Taiwan:Chung Hua Polytechnic Institute,1997.
[28]卢安琪.国立成功大学医学中心门诊医疗服务品质之实证研究[D].台湾:国立成功大学,2002.Lu An-qi.An empirical study on outpatient service qualityof national cheng kung university[D].Taiwan:NationalCheng Kung University,2002.
[29]Parasuraman A,Zeithaml V A,Berry L L.A conceptualmodel of service quality and its implication for future re-search.[J].Journal of Marketing,1985,49(Fall):41-50.
[30]汤淑贞,黄佳经,廖茂宏,等.物流委外模式导入对医院资材库存管理成效研究及满意度调查[J].医务管理期刊,2004,5(4):438-459.Tang Shu-chen,Hung Chia-ching,Liao Mao-hung,et al.The effectiveness and satisfactory study of introducing out-sourcing distribution operation for hospital inventory man-agement-take one specific hospital as an example[J].Jour-nal of Healthcare Management,2004,5(4):438-459.
[31]黄怡诏,陈郁夫,简祯富.新竹科学园区药品网路订购系统之建置与实证研究[J].医疗资讯杂志,2004,13(2):35-46.Huang Yi-chao,Chen Yuh-fu,Chien Chen-fu.Construc-ting the network medicine order systemfor hsinchu sciencepark and an empirical study[J].The Journal of Taiwan As-sociation for Medical Informatics,2004,13(2):35-46.
[32]张月霞,林倖安,庄芬绮,等.提升手术室器械管理成效之改善专案[J].护理杂志,2010,57(2):70-78.Chang Yu-hsia,Lin Shing-an,Juang Fen-chii,et al.Pro-ject to improve operating room surgical apparatus manage-ment[J].The Journal of Nursing,2010,57(2):70-78.
[33]台大医院医疗体系简介.台大医院网站[R/OL].(2012-07-29).http:∥www.ntuh.gov.tw/About_Us/aboutNTUH/%e9%ab%94%e7%b3%bb%e7%b0%a1%e4%bb%8b.aspx.
[34]周雍强,吴政鸿,陈正刚,等.快乐医疗—工业工程的服务应用[R].科学委员会补助专题研究计划,2010-2013.
[35]陈贻善.台北长庚医院的成功管理模式—医院管理与绩效评估[J].国际医药卫生导报,2001(6):9-10.
[36]吴振隆.工业工程在医疗产业管理之应用[R/OL].(2001-04-18).http:∥bbs.cenet.org.cn/uploadimages/2003112817402473839.pdf
[37]医院现况.马偕纪念医院网站[R/OL].(2012-07-29).http:∥www.mmh.org.tw/intro/intro6.asp.
[38]系所沿革.东海大学工业工程与经营资讯学系网站[R/OL].[2012-07-29].http:∥www.ie.thu.edu.tw/in-tro/pages.php?ID=intro3.