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A network flow approach for tactical resource planning in outpatient clinics

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  • Thu Nguyen
  • Appa Sivakumar
  • Stephen Graves

Abstract

This paper introduces a deterministic model to plan the physician requirements for outpatient clinics to achieve service targets for the appointment lead-times of patients. The Ministry of Health of Singapore has established targets for the median, 95th percentile, and 100th percentile of appointment lead-times for patients, since long appointment postponements are regarded as being unacceptable for health care services. The study is to match the capacity of the healthcare providers to the patient demand for a re-entry system, subject to restrictions on the appointment lead-times for patients. We propose a mixed-integer programming model for planning capacity with the minimization of the maximum required capacity as its objective. In the model we assume a finite planning horizon, deterministic arrivals, multiple types of patients, identical physicians, and dependent demand between types of patients. We solve this model with a Branch and Cut algorithm. We test the model with numerical experiments using real data from the chosen specialty at the outpatient clinic of the studied hospital. The results show the value of the proposed model via a systematic push-pull mechanism in scheduling patients’ requests to minimize the objective. The clinic should use one of the appointment lead-time targets to determine the patients’ appointment dates. Finally, from the sensitivity analyses we demonstrate that the objective is negatively correlated with first-visit patients’ appointment lead-time targets, the discharge rates, and the re-visit patients’ mean appointment lead-time; we find a positive correlation between the first-visit patients’ mean appointment lead-time and the appointment lead-time targets. Copyright Springer Science+Business Media New York 2015

Suggested Citation

  • Thu Nguyen & Appa Sivakumar & Stephen Graves, 2015. "A network flow approach for tactical resource planning in outpatient clinics," Health Care Management Science, Springer, vol. 18(2), pages 124-136, June.
    • Handle: RePEc:kap:hcarem:v:18:y:2015:i:2:p:124-136
    DOI: 10.1007/s10729-014-9284-0
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    References listed on IDEAS

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    1. Santanu Chakraborty & Kumar Muthuraman & Mark Lawley, 2010. "Sequential clinical scheduling with patient no-shows and general service time distributions," IISE Transactions, Taylor & Francis Journals, vol. 42(5), pages 354-366.
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    Cited by:

    1. Thu-Ba T. Nguyen & Appa Iyer Sivakumar & Stephen C. Graves, 2017. "Scheduling rules to achieve lead-time targets in outpatient appointment systems," Health Care Management Science, Springer, vol. 20(4), pages 578-589, December.
    2. Ahmadi-Javid, Amir & Jalali, Zahra & Klassen, Kenneth J, 2017. "Outpatient appointment systems in healthcare: A review of optimization studies," European Journal of Operational Research, Elsevier, vol. 258(1), pages 3-34.
    3. Nguyen, Thu Ba T. & Sivakumar, Appa Iyer & Graves, Stephen C., 2018. "Capacity planning with demand uncertainty for outpatient clinics," European Journal of Operational Research, Elsevier, vol. 267(1), pages 338-348.
    4. Guillaume Lamé & Oualid Jouini & Julie Stal-Le Cardinal, 2016. "Outpatient Chemotherapy Planning: a Literature Review with Insights from a Case Study," Post-Print hal-01324488, HAL.

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