近年來全球伴隨著人口老齡化、疫情與新興疾病的盛行，導致醫療技術運營加速創新及對醫院建築更新與新建需求，而醫院工程在其建築全生命週期管理(Building Lifecycle Management BLM)面臨了許多問題，如用戶的需求性、介面管理、設備器材都需要因應疾病變異性、動態性及醫療科技不斷的進步具備靈活性，因此也增加醫院施工專案的困難度與複雜性；頻繁及重大的變更設計成為施工中不可避免的問題。本研究將以文獻回顧、問卷調查、FAHP來探討與評估醫院施工階段中導致設計變更的關鍵風險因素，藉由變更風險的掌控從而減少醫院施工興建進度延遲及成本超支。
結果顯示使用者需求是最重要的考慮因素，外部和業主PCM相關因素也具有相當的重要性。此研究提供了有用的資訊，可以幫助專案管理者更好地理解專案中的主要問題，並制定相應的解決方案，以確保專案的成功完成，未來可以透過本研究已識別的風險因素，來制定風險緩解策略並評估其有效性。

In recent years, the aging global population, along with epidemic outbreaks and advancements in medical technology, has increased the demand for hospital building renewal and new construction. However, hospital engineering faces challenges in its Building Lifecycle Management (BLM). These challenges include the need for flexible requirements, interface management, and accommodating advancements in medical science and technology, which adds complexity to hospital construction projects. Frequent and significant design changes have become inevitable during construction.

This study utilizes literature review, questionnaire surveys, and FAHP to evaluate key risk factors leading to design changes in hospital construction, aiming to reduce delays and cost overruns by managing change risks. The results highlight the importance of user needs, as well as external and owner-related factors. This study provides valuable insights for project managers to better understand project challenges and develop suitable solutions for successful completion. Future research can focus on developing and evaluating risk mitigation strategies based on the identified risk factors.

摘 要 v
ABSTRACT vi
目 錄 viii
表 目 錄 x
圖 目 錄 xii
壹、緒論 1
一、研究背景 1
二、研究目的 2
三、研究範圍 3
四、研究方法與流程 3
貳、文獻回顧 6
一、模糊理論 6
二、工程設計變更風險因素 7
三、修正式德菲法 9
四、FUZZY AHP的應用 10
五、FDEMATEL(模糊決策實驗室分析法) 15
六、小結 18
參、研究方法及架構 18
一、醫院工程設計變更風險因素 18
二、問卷檢定分析 20
(一)、敘述性統計分析 20
(二)、信度分析 20
(三)、效度分析 21
三、模糊德菲法 23
四、FAHP 24
(一)、建立層級結構及一致性檢定 24
(二)、範圍分析法 28
五、FDEMATEL 33
肆、研究結果與分析 35
一、模糊德菲法分析 35
(一)敘述性統計 35
(二)內部一致性Cronbach's Alpha 37
(三)因素篩選 37
二、FAHP 40
(一)敘述性統計 40
(二)CR&C.R.H檢定 41
(三)醫院工程之設計變更因素優先順序 43
三、FDEMATEL 44
(一)敘述性統計 44
(二)因果關係象限圖 45
四、小結 48
伍、結論與建議 50
一、結論 50
二、未來研究建議 51
參考文獻 52
附錄一、研究問卷 56
(一)第一階段問卷 56
(二)第二階段問卷 61
(三)第三階段問卷 74

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