Business School, Sichuan University, Chengdu, China.
Architecture and Urban-Rural Planning College, Sichuan Agriculture University, Dujiangyan, China.
Health Care Manag Sci. 2019 Mar;22(1):68-84. doi: 10.1007/s10729-017-9421-7. Epub 2017 Oct 9.
This paper investigates appointment scheduling for an outpatient department in West China Hospital (WCH), one of the largest single point of access hospitals in the world. Our pilot data analysis shows that the appointment system at WCH can be improved through leveraging the scheduling window (i.e., the number of days in advance a patient makes an appointment for future services). To gain full insight into this strategy, our study considers two cases, based on if patients are willing to wait for scheduled appointments or not. We developed a stylized single server queueing model to find optimal scheduling windows. Results show that, when patients are less sensitive to time delay (i.e., patients will wait for scheduled services), levering scheduling windows is not effective to minimize the total cost per day of the appointment system. In contrast, when patients are sensitive to time delay (i.e., patients may find services elsewhere), then our model considers the potential cost of physician idle time. The modeling results indicate that the total cost per day is relatively sensitive to the magnitude of scheduling window. Thus, adopting a proper scheduling window is very important. In addition, our study proves that the cost functions of both cases are quasi-concave, which are also validated by actual data drawn from the Healthcare Information System at WCH. A comparison of numerical results between two cases is made to draw further managerial insights into scheduling policies for WCH. Discussion of our findings and research limitations are also provided.
本文研究了华西医院（WCH）门诊预约调度问题，WCH 是世界上最大的单点接入医院之一。我们的试点数据分析表明，可以通过利用预约窗口（即患者提前预约未来服务的天数）来改进 WCH 的预约系统。为了全面了解这一策略，我们的研究考虑了两种情况，即患者是否愿意等待预约。我们开发了一个简化的单服务器排队模型来寻找最佳预约窗口。结果表明，当患者对时间延迟不敏感时（即患者会等待预约服务），利用预约窗口并不能有效降低预约系统的日总成本。相反，当患者对时间延迟敏感时（即患者可能会在其他地方寻找服务），那么我们的模型就会考虑医生空闲时间的潜在成本。建模结果表明，日总成本对预约窗口的大小非常敏感。因此，选择适当的预约窗口非常重要。此外，我们的研究证明了两种情况下的成本函数都是拟凸的，这也通过华西医院医疗信息系统中的实际数据得到了验证。对两种情况的数值结果进行了比较，为 WCH 的调度策略提供了进一步的管理见解。本文还讨论了研究结果和研究限制。
