Premium
Reserving Capacity for Urgent Patients in Primary Care
Author(s) -
Dobson Gregory,
Hasija Sameer,
Pinker Edieal J.
Publication year - 2011
Publication title -
production and operations management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.279
H-Index - 110
eISSN - 1937-5956
pISSN - 1059-1478
DOI - 10.1111/j.1937-5956.2011.01227.x
Subject(s) - overtime , revenue , primary care , operations management , scheduling (production processes) , service quality , computer science , queue , key (lock) , quality of service , service (business) , medical emergency , operations research , medicine , business , family medicine , finance , computer network , marketing , economics , computer security , labour economics , engineering
This paper examines the effect of the common practice of reserving slots for urgent patients in a primary health care practice on two service quality measures: the average number of urgent patients that are not handled during normal hours (either handled as overtime, referred to other physicians, or referred to the emergency room) and the average queue of non‐urgent or routine patients. We formulate a stochastic model of appointment scheduling in a primary care practice. We conduct numerical experiments to optimize the performance of this system accounting for revenue and these two service quality measures as a function of the number of reserved slots for urgent patients. We compare traditional methods with the advanced‐access system advocated by some physicians, in which urgent slots are not reserved, and evaluate the conditions under which alternative appointment scheduling mechanisms are optimal. Finally, we demonstrate the importance of patient arrival dynamics to their relative performance finding that encouraging routine patients to call for same‐day appointments is a key ingredient for the success of advanced‐access.