照護偏鄉慢性病患之醫療人員配置

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姓名

田雅菁(Ya-Ching Tien) 查詢紙本館藏

畢業系所

工業管理研究所

論文名稱

照護偏鄉慢性病患之醫療人員配置
(Medicare Staff Assignment for Patients with Chronic Illnesses in Remote Areas)

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摘要(中)

日新月異的科技發展帶領醫療技術持續提升，同時也使得人類壽命的延長。近年來，無論是已開發國家或是開發中國家皆面臨高齡化人口增長的現象，接踵而至的是龐大的照護需求。老年人的長期照護政策以及照護資源規劃皆成為高齡化國家所需要思考的重要課題，有鑑於此，許多國家醫療衛生資源分配不均之問題，如何公平的分配醫療照護資源，也成為當今長期照護政策實行下所要面對的重要議題。
本研究在現今的長期照護政策背景下，以醫療資源配置作為探討議題。考量到國家在進行資源分配時，資源多半容易集中於人口較密集且交通易達性高以及經濟發展程度高的地區，反觀人口稀疏、交通不便利的偏鄉地區資源相對匱乏。因此，以醫療資源匱乏的偏鄉地區作為探討範圍，透過政策制定和實施，與特定醫院協作，每週於固定時段安排醫生前往偏鄉服務，為偏鄉慢性病患的需求制定回診計畫。本研究主要以醫療照護需求面以及供給面之間的配置作為主題，根據病患在不同疾病的嚴重程度，區分該患者的回診頻率，同時考慮各個專業科別醫師可前往偏鄉服務的期數。藉由數學規劃進行醫師人力配置，在滿足病患需求之前提下，其所需要最少醫師人次，提供醫院具體的參考指標。透過研究結果可得知，各科醫師前往服務的期數列表與每位醫師被指派的頻率，為偏鄉慢性疾病患者帶來更完善的醫療資源。

摘要(英)

The rapid development of science and technology have led to the improvement of medical technology. It also extends of human life. In recent years, both developed countries and developing countries are facing the phenomenon of aging population growth. And the demand of long-term care have become huger. Long-term care policies and care resource planning for the elder are important issues for these countries. There are many countries suffering from unfair distribution of medical and health resources. How to fairly distribute medical care resources have become an important issue within today′s long-term care policy.
This study focuses on the allocation of medical resources which follow the background of today’s long-term care policy. When the country allocates resources, most of the resources are easily distributed in areas which density population, easier accessibility and high economic development. On the contrary, there are lack of resource in the remote areas. Therefore, the scope of this study focuses on the lack of medical resources in the remote areas. The implementation of policies and specific hospital collaboration doctor-arrangements service the patients who suffer from the chronic diseases in remote areas at a fixed time. The core of research is focusing on how to allocate the demand of care and the supply of caregiver. According to known severity of the patient classification refers the frequency of referral. Also, we consider the physician who can travel to the district for weeks to plan the resource allocation. This study uses mathematical programming to calculate the minimum number of physicians that need to satisfy with the whole demand of patients. The results show that each physician’s service week and the frequency of assignment.

關鍵字(中)

★ 長期照護
★ 醫療資源
★ 資源配置

關鍵字(英)

★ Long-Term care
★ Medical resource
★ Resource allocation

論文目次

中文摘要 i
ABSTRACT ii
致謝 iii
目錄 iv
圖目錄 vi
表目錄 vii
第一章緒論 1
1.1 研究背景與動機 1
1.2 研究目的 4
1.3 研究架構及流程 4
第二章文獻探討 6
2.1 長期照護 6
2.1.1 長期照護之意涵 6
2.1.2 長期照護之發展 7
2.2 資源配置 9
2.2.1 一般資源配置 9
2.2.2 醫療資源配置 13
第三章問題描述與研究方法 17
3.1 台灣長期照護概述 17
3.2 問題描述 20
3.3 研究方法 22
第四章基本假設和模型建立 23
4.1 基本假設 23
4.2 定義 25
4.3 數學模型 26
第五章情境設計與結果分析 27
5.1 情境設計 27
5.2 資料與參數設立 27
5.3 結果分析 29
第六章結論與未來建議 34
參考文獻 36
附錄 42

參考文獻

[1] Asante, A. D., Zwi, A. B., & Ho, M. T. (2006). Equity in resource allocation for health: A comparative study of the Ashanti and Northern Regions of Ghana. Health Policy, 78(2-3), 135-148.
[2] Bowers, J., Lyons, B., & Mould, G. (2012). Developing a resource allocation model for the Scottish patient transport service. Operations Research for Health Care, 1(4), 84-94.
[3] Bradley, S. P., Hax, A. C., & Magnanti, T. L. (1977). Applied Mathematical Programming. Addison-Wesley.
[4] Costa Filho, C. F. F., Rivera Rocha, D. A., Fernandes Costa, M. G., & de Albuquerque Pereira, W. C. (2012). Using constraint satisfaction problem approach to solve human resource allocation problems in cooperative health services. Expert Systems with Applications, 39(1), 385-394.
[5] Duque, P. A. M., Castro, M., Sörensen, K., & Goos, P. (2015). Home care service planning. The case of Landelijke Thuiszorg. European Journal of Operational Research, 243(1), 292-301.
[6] European Commission. (2014). Adequate social protection for long-term care needs in an ageing society. European Union.
[7] Farhan, J., & Fwa, T. F. (2016). A decentralized multidistrict optimization framework for system-wide pavement maintenance resource allocation. International Journal of Pavement Research and Technology, 9(3), 214-221.
[8] Gaugler, J. E. (2016). Innovations in long-term care. In George, L., & Ferraro, K. (Eds.) Handbook of Aging and the Social Sciences (Eighth Edition), Elsevier, 419-439.
[9] Guépeta, J., Acuna-Agostb, R., Brianta, O., & Gayona, J. P. (2015). Exact and heuristic approaches to the airport stand allocation problem. European Journal of Operational Research, 246(2), 597-608.
[10] Hopman, P., de Bruin, S. R., Forjaz, M.J., Rodriguez-Blazquez, C., Tonnara, G., Lemmens, L. C., Onder, G., Baan, C. A., & Rijken, M. (2016). Effectiveness of comprehensive care programs for patients with multiple chronic conditions or frailty: A systematic literature review. Health Policy, 120, 818-832.
[11] Jayaramana, R., Torreb, D. L., Malikb, T., & Pearsonb, Y. E. (2015). Optimal work force allocation for energy, economic and environmental sustainability in the United Arab Emirates: A goal programming approach. Energy Procedia, 75, 2999-3006.
[12] Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A., & Jaffe, M. W. (1963). Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychosocial function. Journal of the American Medical Association, 185, 914-919.
[13] Kim, H. B., & Lim, W. (2015). Long-term care insurance informal care and medical expenditures. Journal of Public Economics, 125, 128-142.
[14] Kumara, P., Rosenbergerb, J. M., & Iqbalb, G. M. D. (2016). Mixed integer linear programming approaches for land use planning that limit urban sprawl. Computers & Industrial Engineering, 102, 33-43.
[15] Lapide, L. (1998). Supply chain planning optimization: Just the facts. The Report on Supply Chain Management, Advanced Manufacturing Research, 3-30.
[16] Lawton, M. P., & Brody, E. M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist, 9(3), 179-186.
[17] Lim, G. J., Mobasher, A., Bard, J. F., & Najjarbashi, A. (2016). Nurse scheduling with lunch break assignments in operating suites. Operations Research for Health Care, 10, 35-48.
[18] Lin, D. Y., & Ku, Y. H. (2014). An implicit enumeration algorithm for the passenger service planning problem: Application to the Taiwan Railways Administration line. European Journal of Operational Research, 238(3), 863-875.
[19] Lin, M., Chin, K. S., Wang, X., & Tsui, K. L. (2016). The therapist assignment problem in home healthcare structures. Expert Systems with Applications, 62, 44-62.
[20] Molina-Pariente, J. M., Hans, E. W., Framinan J. M., & Gomez-Cia, T. (2015). New heuristics for planning operating rooms. Computers & Industrial Engineering, 90, 429-443.
[21] Nezamoddini, N., & Khasawneh, M. T. (2016). Modeling and optimization of resources in multi-emergency department settings with patient transfer. Operations Research for Health Care, 10, 23-34.
[22] Notte, G., Pedemonte, M., Cancela, H., & Chilibroste, P. (2016). Resource allocation in pastoral dairy production systems: Evaluating exact and genetic algorithms approaches. Agricultural Systems, 148, 114-123.
[23] Colombo, F., Llena-Nozal, A., Mercier, J., Tjadens, F. (2011). Help wanted? Providing and paying for long-term care. Organization for Economic Co-operation and Development, 37-60.
[24] Rheea, J. C., Donec, N., & Andersonda, G. F. (2015). Considering long-term care insurance for middle-income countries: Comparing South Korea with Japan and Germany. Health Policy, 119 (10), 1319-1329.
[25] Rural Health Information Hub (2017). What are barriers to healthcare access in rural areas? (https://www.ruralhealthinfo.org/topics/healthcare-access, accessed Jul. 7, 2017)
[26] Spyropoulos, C. D. (2000). AI planning and scheduling in the medical hospital environment. Artificial Intelligence in Medicine, 20(2), 101-111.
[27] Szebehely, M., & Trydegård, G. B. (2012). Home care for older people in Sweden: A universal model in transition. Health & Social Care in the Community, 20(3), 300-309.
[28] Tamiya, N., Noguchi, H., Nishi, A., Reich, M.R., Ikegami, N., Hashimoto, H., Shibuya, K., Kawachi, I., & Campbell, J. C. (2011). Population ageing and wellbeing: Lessons from Japan′s long-term care insurance policy. The Lancet, 378 (9797), 1183-1192.
[29] Thomas, S. L., Wakerman, J., & Humphreys, J. S. (2015). Ensuring equity of access to primary health care in rural and remote Australia - what core services should be locally available? International Journal for Equity in Health, 14(1).
[30] Üçtuğ, F. G., & Yükseltan, E. (2012). A linear programming approach to household energy conservation: Efficient allocation of budget. Energy and Buildings, 49, 200-208.
[31] United Nations. (2015). World Population Ageing.
[32] Wang, T., Meskens, N., & Duvivier, D. (2015). Scheduling operating theatres: Mixed integer programming vs. constraint programming. European Journal of Operational Research, 247(2), 401-413.
[33] Ward, B. W., & Schiller, J. S. (2013). Prevalence of multiple chronic conditions among US adults: Estimates from the National Health Interview Survey, 2010. Preventing Chronic Disease, 10, 1-15.
[34] Won, C. W. (2013). Elderly long-term care in Korea. Journal of Clinical Gerontology & Geriatrics, 4, 4-6.
[35] 王培東(2006)。疾病發生的測量：發生率(Incidence)和盛行率(Prevalence)。台灣醫界，49(4)，29-33。
[36] 衛生福利部(2007)。我國長期照護十年計畫摘要本。
[37] 衛生福利部(2015)。104年國人死因統計結果。2016年10月12日，取自：http://www.mohw.gov.tw/news/572256044。
[38] 衛生福利部(2015)。推動全方位偏鄉離島醫療照顧體系。
[39] 衛生福利部(2016)。長期照護十年計畫2.0(106年~116年)。
[40] 衛生福利部中央健康保險署(2012)。全民健康保險雙月刊－第100期。
[41] 李世代，劉美吟，高琇珠，曾淑琪，謝鶯玉，蔡淑娟，曾韻霜，劉曼莉與宋珮珊(2009)。日本、韓國長期照護保險內容與相關法令之研究。行政院經濟建設委員會委託之專題研究成果報告。
[42] 吳淑瓊，蕭玉煌，劉玉蘭，林萬億，陳永豐與李貴榮(2001)。考察英國、德國及瑞典長期照護制度報告書。行政院建構長期照護體系先導計畫－出國報告。
[43] 吳瑞堯與周駿賢(2011)。運用資料探勘技術於六大死因慢性疾病之研究。資訊管理學報，18(1)，187-211。
[44] 林奏延，鄧素文，黃三桂，李偉強，林慶豐，許明暉，曲同光，陳快樂，李美珍，邱淑媞，張峰義，簡慧娟，周志浩，蔡魯，蔡誾誾，王宗曦，張雍敏，蔡淑鈴，林阿明，陳昶勳，鄭淑心，郭泰宏，顏鴻章，蔡行瀚，劉玉娟，李玉蕙，張瓊丹，林進修(2014)。從山到海的關懷：邁向國際級偏鄉離島醫療與照顧。衛生福利部。
[45] 梁亞文，劉立凡與林育秀(2010)。英日兩國長期照護制度對推動我國長期照護制度之意涵。長期照護雜誌，14 (3)，311-324。
[46] 張鈺旋(2014)。綠色奇蹟全民健保山地離島醫療服務紀實。衛生福利部中央健康保險署。
[47] 黃紅選與韓繼業(2006)。數學規劃。清華大學出版社。
[48] 楊志良(2010)。我國長期照護現況與展望。研考雙月刊，34(3)，86-91。
[49] 廖興中(2014)。臺灣基層醫療缺乏區域界定之初探：整合空間與非空間因素的分析。行政暨政策學報，58，121-152。

指導教授

王啟泰(Chi-Tai Wang)

審核日期

2017-7-12

推文