Skip to main content
SpringerLink
Log in

Medical appointment overbooking and optimal scheduling: tradeoffs between schedule efficiency and accessibility to service

  • Published:
Flexible Services and Manufacturing Journal Aims and scope Submit manuscript

Abstract

Appointment overbooking has been commonly adopted for the mitigation of the adverse consequences of patient no-shows, such as reduced resource utilization and revenue. However, if there are more patients showing up than expected, the resource overtime and patient waiting time can increase. Due to the theoretical interest and the practical importance of the problem, there has been much research on the design of appointment schedules for the optimization of various performance measures. The adoption of appointment overbooking can also enhance the accessibility to medical service, by reducing the time between the date of calling for an appointment and the appointment date. Compared with the within-the-session schedule efficiency, the appointment lead time has drawn relatively little attention from researchers. In this research, we propose a framework that utilizes a stochastic mixed-integer linear program, which determines an optimal appointment schedule, for a simulation model for guiding the scheduling decisions. With this framework, we conduct a comprehensive analysis of the tradeoffs between schedule efficiency and accessibility to service. We first derive theoretical properties of our stochastic programming model. Then, we conduct computational experiments to examine the convergence of the stochastic mixed-integer linear programming model, the benefits of optimal appointment scheduling, the effects of two-dimensional uncertainty on the performance of appointment schedules, and the tradeoffs between schedule efficiency and accessibility to service. Our computational experiments suggest that a session capacity approximate to the request rate can balance the multiple conflicting objectives more effectively. We also examine the effects of a dynamic overbooking policy and a non-homogeneous appointment request rate. The computational results suggest that a fixed capacity policy can be as effective as a dynamic overbooking policy under the setting of a constant request rate; but the dynamic overbooking policy leads to a slightly better performance under the setting of a non-homogeneous appointment request rate.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13
Fig. 14
Fig. 15

Similar content being viewed by others

References

  • Ahmadi-Javid A, Jalali Z, Klassen KJ (2017) Outpatient appointment systems in healthcare: a review of optimization studies. Eur J Oper Res 258(1):3–34

    Article  MathSciNet  Google Scholar 

  • Alvarez-Oh HJ, Balasubramanian H, Koker E, Muriel A (2018) Stochastic appointment scheduling in a team primary care practice with two flexible nurses and two dedicated providers. Service Science 10(3):241–260

    Article  Google Scholar 

  • Balasubramanian H, Muriel A, Wang L (2012) The impact of provider flexibility and capacity allocation on the performance of primary care practices. Flex Serv Manuf J 24(4):422–447

    Article  Google Scholar 

  • Bendavid I, Marmor YN, Shnits B (2018) Developing an optimal appointment scheduling for systems with rigid standby time under pre-determined quality of service. Flex Serves Manuf J 30:54–77

    Article  Google Scholar 

  • Cappanera P, Visintin F, Banditori C, Di Feo D (2018) Evaluating the long-term effects of appointment scheduling policies in a magnetic resonance imaging setting. Flex Serv Manuf J 30:252–271

    Article  Google Scholar 

  • Cayirli T, Veral E (2003) Outpatient scheduling in health care: a review of literature. Prod Oper Manag 12(4):519–549

    Article  Google Scholar 

  • Cayirli T, Veral E, Rosen H (2006) Designing appointment scheduling systems for ambulatory care services. Health Care Manag Sci 9(1):47–58

    Article  Google Scholar 

  • Cayirli T, Yang KK, Quek SA (2012) A universal appointment rule in the presence of NoShows and WalkIns. Prod Oper Manag 21(4):682–697

    Article  Google Scholar 

  • Cayirli T, Dursun P, Gunes ED (2018) An integrated analysis of capacity allocation and patient scheduling in presence of seasonal walk-ins. Flex Serv Manuf J. https://doi.org/10.1007/s10696-017-9304-8

    Article  Google Scholar 

  • Chakraborty S, Muthuraman K, Lawley M (2010) Sequential clinical scheduling with patient no-shows and general service time distributions. IIE Trans 42(5):354–366

    Article  Google Scholar 

  • Chen, Y., Balasubramanian, H., & Kuo, Y. H. (2017). Appointment overbooking and scheduling: tradeoffs between schedule efficiency and timely access to service. In: Proceedings of the international conference on health care systems engineering, pp 245–255. Springer, Cham

  • Chen, Y., Kuo, Y. H., Balasubramanian, H., & Wen, C. (2015). Using simulation to examine appointment overbooking schemes for a medical imaging center. In: Proceedings of the 2015 winter simulation conference, pp 1307–1318

  • Chen Y, Kuo YH, Fan P, Balasubramanian H (2018) Appointment overbooking with different time slot structures. Comput Ind Eng 124:237–248

    Article  Google Scholar 

  • Gupta D, Denton B (2008) Appointment scheduling in health care: challenges and opportunities. IIE Trans 40(9):800–819

    Article  Google Scholar 

  • Hassin R, Mendel S (2008) Scheduling arrivals to queues: a single-server model with no-shows. Manag Sci 54(3):565–572

    Article  Google Scholar 

  • Ho CJ, Lau HS (1992) Minimizing total cost in scheduling outpatient appointments. Manag Sci 38(12):1750–1764

    Article  Google Scholar 

  • Jiang B, Tang J, Yan C (2019a) A comparison of fixed and variable capacity-addition policies for outpatient capacity allocation. J Comb Optim 37(1):150–182

    Article  MathSciNet  Google Scholar 

  • Jiang B, Tang J, Yan C (2019b) A stochastic programming model for outpatient appointment scheduling considering unpunctuality. Omega 82:70–82

    Article  Google Scholar 

  • Kaandorp GC, Koole G (2007) Optimal outpatient appointment scheduling. Health Care Manag Sci 10(3):217–229

    Article  Google Scholar 

  • LaGanga LR, Lawrence SR (2007) Clinic overbooking to improve patient access and increase provider productivity. Decis Sci 38(2):251–276

    Article  Google Scholar 

  • LaGanga LR, Lawrence SR (2012) Appointment overbooking in health care clinics to improve patient service and clinic performance. Prod Oper Manag 21(5):874–888

    Article  Google Scholar 

  • Lin J, Muthuraman K, Lawley M (2011) Optimal and approximate algorithms for sequential clinical scheduling with no-shows. IIE Trans Healthc Syst Eng 1(1):20–36

    Article  Google Scholar 

  • Liu N, Ziya S, Kulkarni VG (2010) Dynamic scheduling of outpatient appointments under patient no-shows and cancellations. Manuf Serv Oper Manag 12(2):347–364

    Article  Google Scholar 

  • Liu N, Ziya S (2014) Panel size and overbooking decisions for appointment-based services under patient no-shows. Prod Oper Manag 23(12):2209–2223

    Article  Google Scholar 

  • Liu N (2016) Optimal choice for appointment scheduling window under patient no-show behavior. Prod Oper Manag 25(1):128–142

    Article  Google Scholar 

  • Mak HY, Rong Y, Zhang J (2014a) Appointment scheduling with limited distributional information. Manag Sci 61(2):316–334

    Article  Google Scholar 

  • Mak HY, Rong Y, Zhang J (2014b) Sequencing appointments for service systems using inventory approximations. Manuf Serv Oper Manag 16(2):251–262

    Article  Google Scholar 

  • Muthuraman K, Lawley M (2008) A stochastic overbooking model for outpatient clinical scheduling with no-shows. IIE Trans 40(9):820–837

    Article  Google Scholar 

  • Oh HJ, Muriel A, Balasubramanian H, Atkinson K, Ptaszkiewicz T (2013) Guidelines for scheduling in primary care under different patient types and stochastic nurse and provider service times. IIE Trans Healthc Syst Eng 3(4):263–279

    Article  Google Scholar 

  • Qi J (2016) Mitigating delays and unfairness in appointment systems. Manag Sci 63(2):566–583

    Article  Google Scholar 

  • Ratcliffe A, Gilland W, Marucheck A (2012) Revenue management for outpatient appointments: joint capacity control and overbooking with class-dependent no-shows. Flex Serv Manuf J 24(4):516–548

    Article  Google Scholar 

  • Rossi MC, Balasubramanian H (2018) Panel size, office visits, and care coordination events: a new workload estimation methodology based on patient longitudinal event histories. MDM Policy Pract 3(2):2381468318787188

    Google Scholar 

  • Robinson LW, Chen RR (2010) A comparison of traditional and open-access policies for appointment scheduling. Manuf Serv Oper Manag 12(2):330–346

    Article  Google Scholar 

  • Truong VA (2015) Optimal advance scheduling. Manag Sci 61(7):1584–1597

    Article  Google Scholar 

  • Zacharias C, Pinedo M (2014) Appointment scheduling with no-shows and overbooking. Prod Oper Manag 23(5):788–801

    Article  Google Scholar 

  • Zacharias C, Armony M (2016) Joint panel sizing and appointment scheduling in outpatient care. Manag Sci 63(11):3978–3997

    Article  Google Scholar 

  • Zeng B, Turkcan A, Lin J, Lawley M (2010) Clinic scheduling models with overbooking for patients with heterogeneous no-show probabilities. Ann Oper Res 178(1):121–144

    Article  MathSciNet  Google Scholar 

Download references

Acknowledgements

This research is Supported by Macao Science and Technology Development Fund under Grant No. 088/2013/A3, GRF Grant 14202115 from the Hong Kong Research Grants Council, and HMRF Grant 14151771 from Food and Health Bureau, the Hong Kong SAR Government. The authors would like to thank Ms. Valencia Chang, the Administrative Director of the Macau University of Science and Technology Hospital, for providing us with her concerns about appointment scheduling for medical diagnostic tests from a hospital administration point of view. The authors also wish to acknowledge Dr. Chaobai Wen for providing us with the data for this study.

Author information

Authors and Affiliations

  1. Department of Industrial and Manufacturing Systems Engineering, The University of Hong Kong, Pokfulam Road, Hong Kong, China

    Yong-Hong Kuo

  2. Department of Mechanical and Industrial Engineering, University of Massachusetts, Amherst, USA

    Hari Balasubramanian

  3. Department of Decision Sciences, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macau, China

    Yan Chen

Authors
  1. Yong-Hong Kuo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hari Balasubramanian
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yan Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yan Chen.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kuo, YH., Balasubramanian, H. & Chen, Y. Medical appointment overbooking and optimal scheduling: tradeoffs between schedule efficiency and accessibility to service. Flex Serv Manuf J 32, 72–101 (2020). https://doi.org/10.1007/s10696-019-09340-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10696-019-09340-z

Keywords

Search

Navigation