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In this work, we show how real-time length-of-stay (LOS) predictions can beused to divert outpatients from their assigned facility to other facilitieswith lesser congestion. We illustrate the implementation of this diversionmechanism for two primary health centers (PHCs), wherein we divert patientsfrom their assigned PHC to the other PHC based on their predicted LOSs in bothfacilities. We develop a discrete-event simulation model of patient flowoperations at these two PHCs in an Indian district and observe significantlylonger LOSs at one of the PHCs due to disparities in the patient loads acrossboth PHCs. We first determine the expected LOS of the patient at the point intime at which they are expected to arrive at a PHC using system stateinformation recorded at the current time at the PHC in question. The real-timeLOS predictions are generated by estimating patient wait times on a real-timebasis at the queueing subsystems within the PHC. We then divert the patient tothe appropriate PHC on the basis of the predicted LOS estimates at both PHCs,and show through simulation that the proposed framework leads to more equitableutilization of resources involved in provision of outpatient care.

Outpatient Diversion using Real-Time Length-of-Stay Predictions