Coordinated Patient Appointment Scheduling for a Multistation Healthcare Network

• 成果类型: Article
• 署名作者: Wang, Dongyang; Muthuraman, Kumar; Morrice, Douglas
• 署名单位: University of Texas System; University of Texas Austin
• 刊物名称: OPERATIONS RESEARCH
• ISSN/ISSBN: 0030-364X
• DOI: 10.1287/opre.2018.1816
• 发表日期: 2019
• 页码: 599-618
• 关键词: no-shows; service; overbooking; server; ARRIVALS; systems; MODEL

摘要

Current healthcare reforms advocate significantly to improve the coordination of services around a patient-centric model. With most patient care delivered through outpatient services, the need to coordinate scheduling between different services in a hospital or colocated clinics becomes central to successful reform. Currently, outpatient services require independent appointment decisions, and the coordination is left to the patient. This approach causes several inefficiencies, including an increase in missed appointments and unacceptable access delays. This paper proposes a multistation network model that carefully strikes a balance between assumptions that allow tractability and assumptions that disallow real-world adoption. To allow for real-world applicability, we consider sequential appointment scheduling in a network of stations with exponential service times, no-show possibilities, and overbooking. We argue and present evidence that a heuristic myopic scheduling policy is close to optimal. However, because it is not simple enough for practical implementation, we explore a sequence of approximations and find one that offers a significant computational advantage. We also provide several managerial insights and discuss how network structures affect complexity.