1、醫療產業供應鏈現況與未來,供應鏈管理重要議題-1,一般供應鏈最佳化問題考慮因素 物流議題：總系統成本醫療供應鏈最佳化問題考慮因素 醫療議題：病人安全 物流議題：總系統成本,供應鏈管理重要議題-2,一般半成品及產品特性 競爭市場醫療藥品特性 服務業無半成品及產品 獨占性：藥品受專利期限保障 寡占性：藥品受專利期限保障，但有其他藥品可取代性 競爭性：已無專利期限保障,供應鏈管理重要議題-3,一般產業與供應商關係 合作愈緊密愈好醫院與供應商關係 獨占性：合作愈緊密愈好 寡占性：合作 競爭性藥品：競標,供應鏈管理重要議題-4,一般產業物流配送 強調JIT醫療產業物流配送 藥品血液配送JIT可? 安全存
2、量重要性,供應鏈管理重要議題-5,一般產業供應鏈系統成本計算方試 單一(多)供應商+單一製造商+顧客配送醫療產業 單一藥品供應商+醫院策略聯盟,如何促使醫療供應鏈成功,醫療部藥品採購方式 藥品庫存管理 溝通、再溝通 醫院文化 醫療專業術語 醫院管理人員角色,The APP strategies selected in SCM of the hospitalPublish in International Journal of Services and Technology Management,Abstract-1,This paper used the real case, Taiwans
3、Middle Alliance of Department of Health (TMADH), to explore the selection of suitable strategies of aggregate production planning (APP) in the supply chain management (SCM) of the hospital. The simulation method was used to simulate the six different APPs strategies for further evaluating the result
4、s of multiple objectivestotal cost (TC), average service level (S.L), and average changes of production rate (P.R).,Abstract-2,This paper used the method of TOPSIS and fuzzy linguistic to compare different weights in different objectives to obtain the selecting sequence of the APP strategies for the
5、 decision-maker in the hospitals SCM, The result shows that the decision-maker only needs to apply the historical data for the APP strategys planning to obtain the superior solution. That is, decreasing the complexity of decision process for selecting APP strategy as the production policy of SCM is
6、the primary contribution in this paper.,Statement of the APP problem of TMADH -1,Statement of the APP problem of TMADH -2,The TMADH includes seven public hospitalsFong-Yuan Hospital, Yun-Lin Hospital, Taichung Hospital, Changhua Hospital, Nantou Jungshing Hospital, Tsao-Town Psychiatric Center, and
7、Taichung Chronic Disease Control Institutionand every hospital must use the Internet platform to purchase medical products. The distribution center is established in a virtual organizationcomputer center. These seven hospitals purchasing system to computer center is called e-health purchasing system
8、.,Statement of the APP problem of TMADH -3,when the hospital wants to procure medical products, purchasing professionals use the e-health purchasing system to order the purchasing items. JIT (just-in-time) is designed in the delivery system. In addition, in order to avoid the shortage of medical pro
9、ducts, the inventory is set in the contracting pharmaceutical companies. So, this paper is to connect the e-health purchasing system to the pharmaceutical companies, and to consider the transportation of medical products for hospitals demand in order to construct the TMADHs SCM.,Statement of the APP
10、 problem of TMADH -4,Three main viewpoints are established for the TMADHs SCM. One is “to eliminate waste,” another is “to benefit from discount,” and the other is “to handle the channel.” What is “to eliminate waste?” Based on the structure of alliance, the size of every public hospitals warehouse
11、is eliminated as soon as possible and the inventory is set in the pharmaceutical companies. Additionally, hospitals should consider not only the cost but also, most importantly, the patients safety. Therefore, the enhancing service level for most hospitals and for emergent use would also be required
12、.,Statement of the APP problem of TMADH -5,“To benefit from discount” means that the distribution center computes the APPs production quantity. With the “benefit from discount” equation, the hospital can decrease the unit price of medical products. “To handle the channel” means that the distribution
13、 center can further understand the contracting suppliers (pharmaceutical companies) in the reliability and coordination of supply and transportation. According to the theory of JIT, the suppliers are evaluated in order to obtain the appropriate numbers of suppliers.,Statement of the APP problem of T
14、MADH -6,The seven public hospitals send the demands of medical products through the network to the distribution center; then after collecting the demand data, the distribution center computes the APPs production policy to obtain these medical products (the discount quantity is considered here in ord
15、er to obtain the benefit from the saving cost) through the Internet transmitting to pharmaceutical companies.,Statement of the APP problem of TMADH -6,Additionally, the operation mode of material flow is that pharmaceutical companies directly transport the medical products to these seven hospitals.
16、The transportation quantity is 50 lots for each vehicle. Every lot has 200 medical products. Owing to the different medical products of the same product family, the different medical products have the same the package size. The patient safety is the most important factor in the public hospital. So,
17、if the transportation quantity is less than 50 lots, these medical products also need to be delivered.,Statement of the APP problem of TMADH -7,This paper selects the appropriate objectives from the (Masud and Hwang, 1980; Krajewski and Ritzman, 1990; Nam and Logendran, 1992; Wang and Fang, 2001; Ch
18、en and Liao, 2003) which are 1) To maximize net profit, 2) To maximize utilization of production resource, 3) To maximize customer service, 4) To minimize inventory level, 5) To minimize the changes of production rate, and 6) To minimize the changes of workforce level.,Statement of the APP problem o
19、f TMADH -8,Then, after considering the SCM of TMADH, the appropriate multiple objectives are 1) To minimize total cost (TC), 2) To maximize average service level (S.L), and 3) To minimize average changes in production rate (P.R). The objective of “to minimize total cost” includes the purchasing cost
20、, inventory cost, setting cost, and transportation cost.,Research method-TOPSIS,In this paper, the authors used TOPSIS to solve the MADM problem of selecting the APP strategys sequence. TOPSIS, which was developed by Yoon (1980) and Hwang et al. (1981, 1995), is popular in using an intuitive princip
21、le to solve MADM problems in the last two decades. With TOPSIS, the optimal alternative is closest to the ideal solution and furthest from the negative-ideal solution. To sum up, the ranking of alternatives in TOPSIS is based on “the relative similarity to the ideal solution”, which avoids the situa
22、tion of having same similarity to both ideal and negative-ideal solutions.,Fuzzy linguistic for the APPs six strategies-1,The decision-maker maybe faces the conflict among the objectives-Min TC, Max S.L, and Min P.R, a different measurement unit for each objective, and a difficulty in assigning a se
23、t of weights based on relative importance to each objective. This paper uses the fuzzy linguistic to solve these problems.,Fuzzy linguistic for the APPs six strategies-2,the fuzzy ranking method is used to transform the crisp scores to the fuzzy numbers. According to the fuzzy numbers, the relative
24、high, medium, and low importance is in the simplest scale 3. The fuzzy numbers of scale 3 show the high is 0.833, the medium is 0.500, and the low is 0.166. In this paper, by a simple calculation, the authors normalize these 3 fuzzy numbers as the fuzzy weights of TC, S.L, and P.R. The normalized fu
25、zzy weights can be 0.5557 , and the other two fuzzy weights are 0.3336 and 0.1107.,Fuzzy linguistic for the APPs six strategies-3,In this paper, the authors use the 1000 simulation runs for each APP strategies and to obtain the average TC, SL, and PR; then the fuzzy weights are assigned to the three
26、 objectives, and TOPSIS is calculated for the selecting sequence of APP strategies for the practical application.,Conclusion-1,Using S6, S3,or S2, these three strategies are based on historical demand data. That is, the decision-maker can simplify the APP selected strategies; it is not necessary to
27、formulate the complicated model as many researches to solve the complicated APP problems of the real case of the hospitals SCM.,Conclusion-2,With the special case for the comparison of the results of ANOVA for single objective and the results of TOPSIS for “the consideration of multiple objectives i
28、n which only one objective is especially important”, it shows that there are some differences in the selecting sequence for APP strategies. The reason lies in that ANOCA is assumed as the type I error, while TOPSIS is not.,Conclusion-3,Finally, future study can further extend the relative SCM model, increase some criteria such as average time of shortages or average number of shortages periods, capture other variables, or tradeoffs that may exist in a complicated hospitals problem of SCM.,
