策略聯盟醫院衛材聯合供應路徑研究

Vehicle Routeing Problems in the Integrated Medical Material Supply of Strategic Alliance Hospitals

為因應總額支付制度的實施及醫療合理化，目前多由醫學中心與區域醫 院、地區醫院或診所等建立一策略聯盟醫療網，而物料供應系統的合作即是 聯盟醫院可大量降低成本的一環。在策略聯盟各醫院、診所因相對距離、規 模等大小不一，如何使得策略盟聯醫院整體供應系統之運輸供應成本費用達 到最小，為本研究之首要目標。先以各醫院之需求量及相對距離，建立車輛 路徑規劃模式，以求解其途程數、總距離及總運送成本，再應用禁忌搜尋 法，尋求近似最佳的供應途程數、距離及總運送成本。本研究於醫藥材聯合 供應中心方面，嘗試找出個案較佳的配送週期天數、車輛容積及供應中心設 置地點等條件，再以最佳條件組合方式，重新求解供應途程數、總距離及總 運送成本；而在禁忌搜尋法方面，亦於過程中試圖找出個案較佳的求解送代 次數、禁忌名單長度及鄰近解個數，以期使所求之解趨近最佳。最後與現行 營運供應中心之情況做一比較，研究結果顯示：本研究的求解品質尚佳，將 可使得策略聯盟醫院的整體醫藥材聯合供應運輸成本獲得下降58.83% 。同時 亦對配送週期天數、車輛類型及供應中心地點等提出實質上的建議。

Due to the implementation global budget and health care rationalization, strategic alliance had become a trend in health care system in Taiwan. It is also believed that the integrated supply of medical materials among strategic alliance hospitals will reduce health cost effectively. This research aims to solve the vehicle routeing problems, especially in the integrated supply of medical materials among the strategic alliance hospitals. The advantage of the proposed model is to minimize transportation cost required in the integrated supply system. The tabu search has been chosen to solve this problem. First of all, this research tries to tune the parameters in the tabu search, including the size of tabu list, number of iterations, and size of neighborhood solutions. Based on the data provided by a medical center and the approach developed in this research, it found a better aggregated planning period, a better loading capacity of vehicle, and a better location of supply center. It is suggested that the near optimal solution will cut down the supply cost up to 58.83%.