醫療院所內各科門診前經常有許多病患在等待看診，也常見病患與醫護人員抱怨等待過長，因而起衝突。這樣的情況不僅使病患的就醫滿意度下降，也使醫院服務的品質降低。病患等待時間過長包含許多原因，例如上午時段門診開始時，病患尚未抵達，而接近中午時大批病患才湧入，導致門診無法消化。另外，病患等待看診時間過長，看診時間卻很短，會使病患滿意度過低。在全民健保的體制下，影響了醫療的現況，導致醫護人員勞動條件惡化。由於健保給付過低，減少醫療人員的薪資，造成醫療品質下降。從供需角度來看，醫師供給由衛生福利部嚴格控制總量管制，當供給總量嚴格管制，而病患醫療需求爆增的情況下，醫師的工作量將過度增加。在這樣的現況之下，是否能有方法能夠減少病患等待時間，或改善醫師工作情況便成為了本文希望能夠探討的議題。

本研究使用模擬軟體(ARENA)針對案例醫院骨科門診進行模擬，在建立模擬模型之前，需先設立假設利於模擬模型的建立，且需分析骨科病患的類別，因為後續本研究將透過病患的類型重建新的掛號預約系統，以及取得相關的時間分配，包含看診時間與檢查時間等。並且了解門診流程，將現實系統運行的邏輯套入模擬模型中，使之貼近真實系統。分析後得知有四種類型之病患，因此將會有24種不同排序方式，我們將透過模擬方式分析出何種排序擁有最短的總體等待時間。

根據模擬結果排序方式Type1、Type4、Type2、Type3為最佳排序規則，依此結果本研究建議案例醫院骨科門診可採用此掛號預約規則建構新掛號預約系統。往後再針對不同科別及醫療院所調整預約系統的規則。

There are many patients waiting for the doctor in front of the outpatient clinics in medical institutions. It is also common for patients and medical staff to complain that they are waiting too long and have conflicts. Such a situation not only reduces the patient's satisfaction with medical treatment, but also reduces the quality of hospital services. There are many reasons for patients to wait too long. For example, when the clinic starts in the morning, the patient has not arrived, then a large number of patients arrive near noon, which makes the clinic congested. Under the system of National Health Insurance, it has affected the current situation of medical care, resulting in the deterioration of the working conditions of medical staff. In this situation, whether there are ways to reduce patient waiting time or improve the work of physicians has become an issue that this article hopes to explore.

This study used simulation software (ARENA) to simulate the orthopaedic clinic of the case hospital. We know that there are four types of patients, so there will be 24 different sequence methods. We will analyze the sequence method to have the shortest overall waiting time through simulation.

According to the simulation results, the sequence methods Type1, Type4, Type2, and Type3 are the best rules. According to the results, this study suggests that the orthopedic clinic can use this registration rule to construct a new appointment system.

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