運用關聯法則探勘某偏遠基層診所流失病患特性兼論運算法改進之研究

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Title:	運用關聯法則探勘某偏遠基層診所流失病患特性兼論運算法改進之研究 On the Characteristics of the Patient Churn of a Remote Health Center Using Association Rules with the Modification of Algorithm
Authors:	黃瑞明 Jui-Ming Huang
Contributors:	陳俞成嘉南藥理科技大學：醫療資訊管理研究所
Keywords:	客戶流失關聯法則 CNCH演算法忠誠度 loyalty CNCH alogorithm association rule patient churn
Date:	2008
Issue Date:	2010-06-01 09:21:32 (UTC+8)
Abstract:	疾病除生理上的病痛外，又涉及文化傳統的基本觀念與態度，例如疾病的命名與分類，疾病的認識與經驗，疾病的解釋與處置等。因此就醫行為受到釵h因素的影響。國內、外過去研究調查結果顯示：病患的就醫行為受到病患本身的疾病因素所影響，如病患選擇就醫醫院層級與平均看診次數等，這也直接影響病患對醫師或醫療院所的忠誠度，慢性疾病患者，忠誠人數百分比多高於急性疾病患者，顯示慢性疾病患者較急性病患者願意尋求同一醫師就診。性別也會影響病患是否具有高忠誠度，各研究調查之研究方法或研究期間上的差異，使得結果並不一致。大部份研究發現，相同性別變數對不同疾病產生的忠誠度並不一樣。年齡同樣為影響病患是否具有忠誠度的重要因素，多數的研究結果顯示，年齡愈高者較為忠誠。有些研究則認為相同年齡變數對不同疾病產生的忠誠度也不相同。區域特性方面，研究結果多認為醫療資源的可近性或方便性，會影響病患選擇就醫場所，而區域因素包含：醫院的可近性、醫療資源集中程度與當地民眾之就醫文化習慣等。醫療資源豐富的地區，其病患的忠誠度較低。即使同區域之醫療院所病患對其忠誠度亦不全然相同。本研究以七股鄉衛生所為個案，探討衛生所於民國89年至96年8年間，門診病患流失及影響病患忠誠度的相關因素。利用關聯法則發現病患流失之特性組合，就診次數少者、年輕族群、居住於鄉境，性別則影響支持度大小，疾病種類和其忠誠度似乎並無關係。採用合併、直接分解成設定的組合項目，命名為CNCH演算法，在效率及速度上優於Apriori演算法及Summary topdown演算法。 Disease include the physical discomfort and the cultural attitude or concept, thus medical care seeking behavior is a multifactor issue. Various researches show that the seeking behavior is affected with the disease and the loyalty to the doctor is also influenced by the seeking behavior. Generally speaking , patients of chronic disease have the more loyalty than that of the acute. The gender may also affect the loyalty of the patient to the doctor or health provider.Different research method or period resulted in different conclusion. Most opinions agree the relation between the loyalty and the gender. Age is another import factor affecting the loyalty. Many studies got the result that the older the age, the more in the loyalty. There are some investigations showed that the affecting calibre is not uniform. Medical resource include the accessibility and the convenience to the health care, it may influence the decision-making of the patient. The attribute of the region comprise of the accessibility to the healthcare, the degree of the centralization of medical resource and the cultural habit of the dweller of the medical care seeking behavior. The more rich of the medical resource, the less in the loyalty. Even in the same health care service, different doctor or department may have the different loyalty from the patient. The subject of this study is the churn OPD (out-patient department) patient of Cigu health center of Tainan between 2000 and 2007,totally with 2900 patients. We use the association rule of SPSS Clementine to find the characteristics of the loss patient. Low visiting frequency, young people, resident of town center and the gender are the attribute of potential candidate of itemset. But the attribute of disease is not. We also develop a CNCH alogorithm which is efficiently better than that of the Apriori or STD (Summary topdown).
Relation:	校內一年後公開，校外永不公開
Appears in Collections:	[Dept. of Hospital and Health (including master's program)] Dissertations and Theses

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