Skip to main content
Log in

Designing appointment scheduling systems for ambulatory care services

  • Published:
Health Care Management Science Aims and scope Submit manuscript

Abstract

The current climate in the health care industry demands efficiency and patient satisfaction in medical care delivery. These two demands intersect in scheduling of ambulatory care visits. This paper uses patient and doctor-related measures to assess ambulatory care performance and investigates the interactions among appointment system elements and patient panel characteristics. Analysis methodology involves simulation modeling of clinic sessions where empirical data forms the basis of model design and assumptions. Results indicate that patient sequencing has a greater effect on ambulatory care performance than the choice of an appointment rule, and that panel characteristics such as walk-ins, no-shows, punctuality and overall session volume, influence the effectiveness of appointment systems.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bailey NT (1952) A study of queues and appointment systems in hospital outpatient departments with special reference to waiting times. Journal of the Royal Statistical Society 14: 185–199

    Google Scholar 

  2. Arbitman DB (1986) A primer on patient classification systems and their relevance to ambulatory care. The Journal of Ambulatory Care Management 9: 58–81

    Google Scholar 

  3. Cox TF, Birchall JF, Wong H (1985) Optimizing the queuing system for an ear, nose and throat outpatient clinic. Journal of Applied Statistics 12: 113–126

    Google Scholar 

  4. Klassen KJ, (1996) Rohleder TR Scheduling outpatient appointments in a dynamic environment. Journal of Operations Management 14: 83–101

    Article  Google Scholar 

  5. Vanden Bosch PM, Dietz CD (2000) Minimizing expected waiting in a medical appointment system. IIE Transactions 32: 841–848

    Article  Google Scholar 

  6. Walter SD (1973) A comparison of appointment schedules in a hospital radiology department, British Journal of Preventive and Social Medicine 27: 160–167

    Google Scholar 

  7. Cayirli T, Veral E (2003) Outpatient-scheduling in health care: A review of the literature. Production and Operations Management 12: 519–549

    Google Scholar 

  8. Nuffield Provincial Hospitals Trust, Waiting in Outpatient Departments: A Survey of Outpatient Appointment Systems (Oxford University Press, London, 1965)

  9. Partridge JW (1992) Consultation time, workload, and problems for audit in outpatient clinics, Archives of Disease in Childhood 67: 206–210

    Google Scholar 

  10. Ho C, Lau H (1992) Minimizing total cost in scheduling outpatient appointments. Management Science 38: 1750–1764

    Google Scholar 

  11. Wang PP (1997) Optimally scheduling N customer arrival times for a single-server system. Computers & Operations Research 24: 703–716.

    Google Scholar 

  12. Robinson LW, Chen RR (2003) Scheduling doctors' appointments: Optimal and empirically–based heuristic policies. IIE Transactions 35: 295–307

    Google Scholar 

  13. Denton B, Gupta D (2003) A sequential bounding approach for optimal appointment scheduling. IIE Transactions 35: 1003–1016.

    Article  Google Scholar 

  14. Soriano A (1966) Comparison of two scheduling systems. Operations Research 14: 388–397

    Google Scholar 

  15. Blanco White MJ, Pike MC (1964) Appointment systems in outpatients' clinics and the effect on patients' unpunctuality. Medical Care 2: 133–145

    Google Scholar 

  16. Vissers J, Wijngaard J (1979) The outpatient appointment system: Design of a simulation study. European Journal of Operational Research 3: 459–463

    Article  Google Scholar 

  17. Yang KK, Lu ML, Quek SA (1998) A new appointment rule for a single-server, multiple-customer service system. Naval Research Logistics 45: 313–326.

    Article  Google Scholar 

  18. Rising E, Baron R, Averill B (1973) system analysis of a university health service outpatient clinic. Operations Research 21: 1030–1047

    Google Scholar 

  19. Swartzman G (1970) The patient arrival process in hospitals: Statistical analysis. Health Services Research 5: 320–329

    Google Scholar 

  20. Swisher JR, Jacobson SH, Jun JB, Balci O (2001) Modeling and analyzing a physician clinic environment using discrete-event (visual) simulation. Computers & Operations Research 28: 105–125.

    Article  Google Scholar 

  21. Fetter R, Thompson J (1966) Patients' waiting time and doctors' idle time in the outpatient setting. Health Services Research 1: 66–90

    Google Scholar 

  22. Shafer SM, Smunt TL (2004) Empirical simulation studies in operations management: Context, trends, and research opportunities. Journal of Operations Management 22: 345–354

    Google Scholar 

  23. Law AM, Kelton WD (1991) Simulation Modeling and Analysis (McGraw-Hill, New York).

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tugba Cayirli.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cayirli, T., Veral, E. & Rosen, H. Designing appointment scheduling systems for ambulatory care services. Health Care Manage Sci 9, 47–58 (2006). https://doi.org/10.1007/s10729-006-6279-5

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10729-006-6279-5

Keywords

Navigation