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Zugl.: Münster (Westfalen), Univ., Diss., 2008

Business is often about creating change for other businesses. At times, these changes affect only the company and at other times they affect the entire industry. There is a time in the life of a business when its fundamental way of functioning is questioned and is subjected to change. That change can mean an opportunity to rise to new heights, or it might even signal the beginning of the end. This fundamental change in any business is known as an inflection point. Understanding the nature of its inflection point and responding to that point suitably will help to safeguard a company's growth. So today's managers, when faced with such changes, have to be equipped with the adequate tools to guide the company out of troubles and to place it in a position where it can prosper. The fundamental changes can be scrutinized by studying the internal dynamic behavior of the system. Therefore, the managers are required to be systems thinkers so that they can study the internal dynamic behavior of the company and maneuver the inflection point successfully. System dynamics is an effective tool, which helps the managers to understand the structure and internal dynamic behaviors of a large and complex system. System dynamics models are developed to assist the management to navigate its way through the inflection point. This thesis focuses on how system dynamics model-analysis and model based policy development process can help a company to overcome an inflection point. Further enhancements and calibrations can be done to the model to provide industry specific solutions.

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Since the systems of health insurance of the whole people were run in March of the 84th year of the Republic of China, it is very near to offer medical treatment to the best patient in the whole world, the highly free right to choose of seeking medical advice, and high-quality medical care. But cause the expense expenditure of the hospital to rise continuously, is strong in protecting the office as because in conformity with the financial situation, pursue a lot of financial retrenchment policies successively, cause uncertainty and complexity of the medical industry's environment. Especially pay the system so far the total value of the hospital, decline in the development in economy of the whole world depressedly, domestic aging of population, unemployment increase, medical resources are insufficient day by day and strong in assuaring the financial affairs are left pressingly, the central health insurance bureau is paid the system and controls the cost, adjust and pay the standard progressively, towards pay, standardize while being single, so reform pay medical the intersection of institutes and way pay system for TW-DRGSs ' diagnose related group in hospital ' stage by stage year by year from January of 1999. Made in Singapore after setting out on a journey, future so long as medical resource more close part will be sorted out into the same class, in accordance with kinds of Diseases, operation, age, gender, amalgamate condition classification such as disease, divide into groups according to the weight grade of the condition, pay by norm, is lower than lower limit, will adopt and verify that declare the way, that is to say ' pay the system with severity and reward '. The government implements the policy purpose of ' TW-DRGSs ', except the efficiency of serving for raising medical treatment, reduce the waste, also can improve patient, look after quality and curative effect, let the intersection of hospital and the intersection of cost and optimization, but the implementation of DRG will cause the suitable impact of the hospital, may aggravate looking after and financial responsibility and risk of the medical organization. But hospital attribute( Set objectives, the intersection of role and localization, organization and the intersection of power and responsibility and structure,etc.) Different, the hospital faces being strong in assuaring that it and because will be different to pay the financial pressure that the system changes in conformity with ways, except army's hospital in the country shoulders the country and looks after soldier's healthy policy responsibility, pay attention to managing the performance even more. So because should be strong in assuaring that it will be different to pay measure and efficiency that the system's changing takes and lowers costs to some extent, and these differences will react on the manifestation of financial performance indicators such as its medical care amount, income and interests,etc.. Satisfied how to promote the financial performance of the hospital, give consideration to operations objective, medical care quality and patient of the hospital at the same time, key factor that will be managed continuously forever for the hospital. Until ' diagnose related group in hospital ', first serious the intersection of case and clinical route standardize, influence clinical the intersection of route and standardization make, act as, in hospital number for the first time, so this research institute builds the systematic dynamics model constructed, the ones that chose the first stage to implement 155 items of TW-DRGSs were in hospital in days, the hospital TW-DRGSs case number, take bed rate and satisfaction in hospital etc., these influence each other the simulation of the relation value adopts Table function to imitate. And Table function which this research institute puts forward passes the true data in often operation course on ordinary days of case hospital, observe and experience judgement or relevant literature consult materials of income, performance its weigh the intersection of indicator and system can represent the intersection of country and the intersection of army and the intersection of hospital and case only, can't prove why the other scale hospitals are appropriate; And this research is paid and imitated according to the systematic way of case hospital alone, as system way may present different results not simultaneously. Expect to give the case hospital some suggestions in managing, managing and is made with the clinical route through this research, the colleagues of staff of different levels work satisfiedly in safeguarding patient's whole rights and interests, courtyard, promote the quality of medical care, the purpose of this research: (1)Make use of system of macroscopic think way, canvass the intersection of case and hospital, implement, good for, protect TW-DRGSs at the system, the influence that the management in hospital stays runs to the case hospital for a long time, and can assist the case hospital to find the optimum management effect. (2)Set up systematic dynamics way, imitate the intersection of case and hospital, divide into annual to implement, good for, protect TW-DRGSs, in hospital management of day to the intersection of hospital and revenue and expenditure, medical behavior and influence to cure the desease relation at the system stage by stage. The concrete suggestion of this research is as follows: (1) Control and manage number in hospital, increase the turnover rate of the sick bed (2) Set up all kinds of disease clinical guiding or clinical routes (3) Improve the hospitalization cost and declare benefit (4) Research of project development at one's own expense

The research desires to evaluate the preventing policies on emerging infectious diseases by system dynamics, and takes the SARS situation in Taiwan for example. According to epidemiology and everything about SARS, we build the model of SARS transmission and prevention. Therefore we can simulate the situation and policies, and find the effective policies. After the simulation and the evaluation, we find that most SARS patients at later stage are affected in hospital. For the reason, the most effective policies are the ¡uPolicy about enhancing protection abilities in hospital¡v and ¡uPolicy about reducing the interaction with people in hospital¡v. Furthermore, the effectiveness of ¡uQuarantine policies¡v is not stronger than the above policies. The most important thing is that we discover Taiwan is very lucky, because the infectivity is very low (about 3.7%). If the infectivity of SARS were as high as 10% and we still took the same policies as we took in 2003, the situation would be terrible. Anyway, when we confront this kind of emerging infectious diseases, the better way is taking policies in hospital intently.

The analysis of economic environment is the basis of well managerial decisions for enterprises. However, the relationship among economic variables in the real world is a kind of dynamic complexity problem. Economics usually take advantage of mathematics to solve this kind of problem. Therefore, it will be very difficult for business administrators to analyze the long-term dynamics competitive. This study integrated system dynamics thinking and dynamics of strategic maneuvering to build a systems feedback model of dynamic competitive environment, which can be used to analyze the long-term dynamics of competitive variables under different scenarios, including the dynamic thinking of growth and core competitive strategy. Linked with balanced scorecard interface, the model will become a decision support system of dynamic competitive analysis, which can provide business administrators with the analytic tool of dynamics competitive environment to improve their decision qualities concerning finance, production, and marketing.

This paper attempts to develop a dynamic alignment approach to leverage design of system dynamics models. The approach developed in this research is a flow-based design, different from traditional macro designs of aggregated system structures or loop analysis. It is grounded on some major concepts in Synchronous management at plants and uses the Drum-Buffer-Rope (DBR) system to align the various operations of rate decisions. This paper takes two famous system dynamics models as examples to examine the performance of the proposed leverage design method. One is the customer-producer-employment model, and the other is the market growth model. Both of the models are developed by Forrester(1961; 1968). By applying the dynamic alignment approach, the redesigned customer-producer-employment system shows that the original oscillation behavior can be fully eliminated, and the redesigned market growth model can sustain its growth pattern instead of stagnation or collapse. By comparison with previous high leverage design methods, the dynamic alignment approach developed in this paper is proved to be more efficient and robust for system redesign in different scenario.