隨著全民健保開辦，全民對醫療保健的重視與日俱增，健康檢查所強調之”預防大於治療”的觀念也逐漸被民眾接受，然而全民健保所提供的健檢內容並不能滿足民眾對自身健康資訊的需要，因此近年來自費健康檢查的醫療服務開始蓬勃發展，市場的競爭也日趨激烈，健檢中心在提供健檢服務以外更要求高受檢者的滿意度。而不良的健檢流程設計將造成受檢者總檢查時間拉長，引發受檢者抱怨，因此健檢中心欲提高其服務品質，則流程的設計便是一項重要的問題。
本研究以馬偕紀念醫院新竹分院健康檢查中心為研究對象，該中心目前便有流程混亂導致受檢者抱怨的問題存在，本研究首先訂定代表受檢者抱怨的指標：受檢者等候超過特定時間之機率，利用模擬進行不同方案的實驗，同時將得到的結果建立再生模式，得到各績效指標與變因之間的關係式，並依照此模式進行改善方案比較。
本研究主要討論的改善方案包括：現場檢查流程、受檢者報到批次與家醫科醫師開始看診時間與受檢者到來情形的敏感度分析，模擬結果得到應採行最短檢驗時間法則，分上午八點、九點兩批報到，而當預期受檢者遲到情形嚴重時，家醫科醫師於上午九點三十分開始檢查，反之則在九點十分開始檢查，同時健檢中心可以給予承諾，若受檢者在通知時間準時報到，則保證檢查將在兩小時四十分鐘內結束。

Due to the establishing of the National Health Insurance (NHI), people are paying more attention to healthcare and asking for more information about the health status of their own than before. The dissatisfaction of the basic examination provided in the NHI leads to an increasing demand for an integrated health examination at their own expense.
In the competitive market of the integrated health examination, managers are putting more emphasis on customer satisfaction. A bad flow design of the health examination may cause a long total examination time, which leads to a lot of complaints of the customers. For this reason, the flow design becomes an important issue in the health examination centers.
Our research is focus on the health examination center of HsinChu Mackay Memorial Hospital which is facing the flow design problem. In this research, the probability of a customer's waiting time exceeding a specific length was chosen as the criterion for complaints of the customers. The experiments of comparing different strategies were done through simulation, and the output data formed the metamodels which we used to understand the relationship between the criteria and the factors. The comparisons of different strategies are based on the metamodels.
The strategies include the examination flow, the numbers of check-in batches of the customers and the time when the doctor of family medicine begins to diagnosis the customers. A sensitivity analysis of different arrival process of customers is also done. The shortest-processing-time rule of examination flow and two check-in batches are suggested in this research. When most of the customers are late, the doctor of family medicine should begin their diagnoses on 9:30AM, or otherwise the doctor should begin at 9:10AM. The research also shows that a promise to the customers can be mde by the center saying if the customers arrive on time, the total examination time of each individual will not exceed two hours and forty minutes.

Brewer, T.F. , Hetmann, S.J., Krumplitsch S.M. ,Wilson M.E., Colditz G.A. and Fineburg H.V.(2001), “Strategies to decrease tuberculosis inUS homeless populations: a computer simulation model”, JAMA, Vol. 286, No. 7 , pp834-842.
Carlson, R.C. and Kropp, D.H.(1977), “Recursive Modeling of Outpatient Health Care Settings”, Journal of Medical Systems, Vol. 1, No. 2 , pp. 123-135.
Dexter, F. and Traub ,R.D. (2002), “How to schedule elective surgical cases into specific operating rooms to maximize the efficiency of use of operating room time“, Anesth Abalg: 94 , Volume 4, pp933-942
England, W. and Roberts ,S.D. (1978), “Applications of computer simulation in health care “, Proceedings of the 10th conference on Winter simulation : December 1978 , Volume 2, pp665-677
Friedman ,L.W.(1996),The Simulation Metamodel, Kluwer Academic Publishers
Groothuis ,S. , Godefridus G. van Merode , Hasman A.(2001), “ Simulation as decision tool for capacity planning”, Computer Methods and Programs in Biomedicine, Vol.66,pp139–151
Hashimoto,F. and Bell, S.(1996), “Improving outpatient clinic staffing and scheduling with computer simulation”, J Gen Intern Med 11:182
Hung, Ying-Chao and Michailidis, G.(2003), “Developing Efficient Simulation Methodology for Complex Queueing Networks”, Proceedings of the 2003 Winter Simulation Conference
Kim, S.C. , Horowitz I. , Young K.K., Buckley,T.A.(2000), “Flexible bed allocation and performance in the intensive care unit ”, Journal of Operations Management , Vol.18 , pp427–443
Kleijnen, Jack P.C.(1994) “Sensitivity analysis and optimization of simulation models”, Procedings of the European Simulation Symposium, October, pp9-12, 1994, Istanbul,Turkey,SCS.
Kleijen, Jack P.C.(1993) “Simulation and Optimization in production planning”, Decision Support Systems 9,pp269-280
Kotler ,P. (1991), Marketing Management—Analysis, Planning, Implementation and Control, 7th edition, Englewood Cliffs, NJ: Prentice-Hall, Inc.
Lane, P.M., Lindquist, J.D.(1998), “Hospital Choice : A Summary of the Key Empirical and Hypothetical Findings of the 1980s.” , Journal of Health Care Marketing, Vol. 8, pp 5-20.
Law A.M. and Kelton W.D.(2000), Simulation Modeling and Analysis, 3rd edition, McGraw-Hill, Inc.
Lin, Li, Jeffery K. Cochran, and Joseph Sarkis(1992)” A metamodel-based decision support system for shop floor production control”, Computers in Industry 19,pp155-168
Lowery, J. C. (1998), “Getting Started in Simulation in Healthcare”, Proceedings of the 1998 Winter simulation conference,PP31-35
McGuire, F. (1997),”Using simulation to reduce length of stay in emergency department”, JSHS, ;5(3),pp81-90
Myers, R.H, Montgomery, D.C.(2002), Response Surface Methodology, John Wiley & Sons, Inc.
Simpson, T., Dennis, L., and Chen, W.(2002),“Sampling Strategies for Computer Experiments: Design and Analysis" , Journal of International Journal of Reliability and Application, 2(3), pp209-240
Swain, J.J.(2003), “Simulation Reloaded: Sixth biennial survey of discrete-event simulation software tools that empower users to imagine new systems, and study and compare alternative designs”, OR/MS Today, August
Schruben, L.W.(2002), Event Graph Simulation
Song W.T. and Su, C.C. (1996), “An extension of the multiple-blocks strategy on estimating simulation metamodels”, IIE Transactions, Vol.28,p511-519
Vogt W. and Braun, S.L. (1994), “Realistic Modeling of Clinical Laboratory Operation by Computer Simulation”, Clinical Chemistry, Vol.40,p922-928
Wilt A. and Goggin D.(1989), “Health Care Case Study: Simulation Staffing Needs and Work Flow in an Outpatient Diagnostic Center”, Industrial Engineering, Vol.12,p22-26
藍采風、廖榮利(1992)，社會醫療學，三民書局
盧瑞芬、謝啟瑞(2000)，醫療經濟學，學富文化事業有限公司
李石燕(1992), ”台北市老人健康檢查經驗之探討”,國立台北護理學校護理研究長所碩士論文
蔡宗仁(1996), ”健檢發展史”,中華民國醫檢會報,11卷,3期pp52-54
李智峰(1997), ”健檢服務業現狀與經營策略之分析”,長庚大學醫學暨工程學院管理研究所碩士論文
侯幸雨(1999), ”應用模擬技術探討台灣醫院門診預約掛號系統”, 國立中正大學企業管理研究所碩士論文
黎家銘(2000), ”全民健康成人健檢實施情形調查分析”, 國立台灣大學醫療機構管理研究所碩士論文
陳秀珠(2003), ”醫療服務品質與病患滿意度非線性關係的探討與應用”, 國立台灣大學商學研究所博士論文
吳欣芳(2002), ”隨機性作業與排序性作業之比較─以台大醫院健檢中心流程為例”,國立台灣大學商學研究所碩士論文
謝淑慧(2002), ”健檢中心之經營策略與經營績效之探討”,國立雲林科技大學工業工程與管理研究所碩士論文
李建廷(2003), ”急診檢查排程系統之研究”,國立暨南國際大學資訊管理研究所碩士論文
林怡君(2003), ”運用模擬技術於手術室排程管理─以某醫學中心為例”,國立台灣大學醫療機構管理研究所碩士論文
陳春枝(2003), ”流程管理介入對手術室服務效能之影響”,台北醫學大學護理研究所碩士論文
行政院衛生署衛生統計資料網站, http://www.doh.gov.tw/statistic/index.htm
馬偕紀念醫院新竹分院網站, http://www.hc.mmh.org.tw/div_int/health/health01.asp