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Patient Appointments in Ambulatory Care

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Handbook of Healthcare System Scheduling

Part of the book series: International Series in Operations Research & Management Science ((ISOR,volume 168))

Abstract

Outpatient appointment system design is a complex problem because it involves multiple stakeholders, sequential booking process, random arrivals, no-shows, varying degrees of urgency of different patients’ needs, service time variability, and patient and provider preferences. Clinics use a two-step process to manage appointments. In the first step, which we refer to as the clinic profile setup problem, service providers’ daily clinic time is divided into appointment slots. In the second step, which we refer to as the appointment booking problem, physicians’ offices decide which available slots to book for each incoming request for an appointment. In this chapter, we present formulations of mathematical models of key problems in the area of appointment system design. We also discuss the challenges and complexities of solving such problems. In addition, summaries of prior research, particularly advanced models related to the examples shown in this chapter are also presented.

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Notes

  1. 1.

    Patients seeking the services of these and surgical specialists usually need a referral for their first appointment. In contrast, patients may book appointments with physicians belonging to the primary-care category without a referral.

  2. 2.

    Percent of visits to solo practices declined from about 39% in 1997 to about 31% in 2007.

  3. 3.

    Note that the current period is indexed 1.

  4. 4.

    This is the national average visit rate.

  5. 5.

    Note that no-shows can be modeled in this setup by assigning a non-zero probability (equal to no-show probability) to the event that the service time is zero (in case of a no-show) while ensuring that patients who do not show up do not incur a waiting cost.

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Acknowledgments

The authors are grateful to Dr. Brian Hertz, Internal Medicine, Hines VA Medical Center and Associate Professor of Internal Medicine, Loyola University, Chicago, for his comments and suggestions for improving an earlier version of this chapter.

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  1. University of Minnesota, 111 Church Street S. E., Minneapolis, MN, 55455, USA

    Diwakar Gupta & Wen-Ya Wang

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  1. Diwakar Gupta
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Correspondence to Diwakar Gupta .

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  1. Viterbi School of Engineering, Dept. Industrial & Systems Engineering, University of Southern California, McClintock Ave. 3715, Los Angeles, 90089-0193, California, USA

    Randolph Hall

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Gupta, D., Wang, WY. (2012). Patient Appointments in Ambulatory Care. In: Hall, R. (eds) Handbook of Healthcare System Scheduling. International Series in Operations Research & Management Science, vol 168. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-1734-7_4

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