Hybrid Outpatient Appointment Policy Considering Patient Behavioral Factors

Hybrid outpatient appointment (HOA) system deals with two kinds of patients’ requests, one with longer appointment lead times and the other with shorter appointment lead times. Therefore, HOA system can increase patient satisfaction effectively, and is adopted by more and more health care providers. But in real outpatient appointment, patients tend to have various behavioral factors, for example, patients have different time-of-day preferences, as well as different degrees of loyalty toward their preferred care provider (PCP); patients may cancel their appointment before accept health care service; patients may do not show up (no-shows) for their appointment on the service day etc. Therefore, it is of great important theoretic and practical significance to research the HOA problem considering patient behavioral factors systematically and propose the appointment policies for the problem.The purpose of this thesis is to make a deep theoretical analysis and methodological research on the HOA problem considering patient behavioral factors. A series of research works are conducted as follows.First, the HOA problem considering patient behavioral factors is described and the geneal theoretical framework for the research problem is proposed. In order to making the research system clear, four research problems are described according to various patient behavioral factors, i.e., the HOA problem considering no-shows, the HOA problem considering cancellation, the HOA problem considering no-shows and cancellation, and the HOA problem considering patient choice. To solve the presented research problems, the general research framework for solving the HOA problem considering patient behavioral factors is proposed.Second, the HOA policy considering no-shows is provided. Specifically, it mainly concludes the following two aspects, i.e.,1) the HOA policy with single doctor considering no-shows is provided. In this policy, overbooking is utilized to offset the negative effect of no-shows, and by determing the optimal appointment number of patients who book in advance to determine which request is accepted.2) the HOA policy with multiple doctors considering no-shows is provided. In this policy, whether the request for one doctor should be accepted is determined by the upper bound of the optimal appointment number of patients who book in advance, which are relevant to both no-show probability and the appointment state.Third, the HOA policy considering cancellation is provided. Specifically, it mainly concludes the following two aspects, i.e.,1) the HOA policy with single doctor considering cancellation is provided. In this policy, the expected revenue model is constructed and the analytical solution is obtained, then the optimal appointment number of patients who book in advance is determined by the analytical solution, and further which request should be accepted is determined by the optimal appointment number.2) the HOA policy with multiple doctors considering cancellation is provided. In this policy, the optimal appointment number of patients who book in advance for each doctor is determined by constructing and solving the expected revenue model with multiple doctors, and then which request of each doctor is accepted is determined by the optimal appointment number for each doctor.Fourth, the HOA policy considering no-shows and cancellation is provided. Specifically, it mainly concludes the following two aspects, i.e.,1) the HOA policy considering no-shows and cancellation is provided. In this policy, the optimal appointment number of patients who book in advance for each appointment period is determined by constructing and solving the expected revenue model, and then which request is accepted is determined by the optimal appointment number for each appointment period.2) the impact analysis of model parameters on HOA policy is provided. The impact of model parameters on HOA policy is provided by sensitivity analysis.Fifth, the HOA policy considering patient choice is provided. Specifically, it mainly concludes the following two aspects, i.e.,1) the HOA policy with single doctor considering patient choice is provided. In this policy, patients’choice behavior of service time is described by discrete choice model, and which request is accepted is determined by determing the optimal appointment number of patients who book in advance.2) the HOA policy with multiple doctors considering patient choice is provided. In this policy, patients’ choice behavior of both service time and doctor is described, and which request is accepted is determined by determing the upper bound of the optimal appointment number of patients who book in advance.The HOA policy proposed by this thesis can be used to solve many other hybrid appointment problems in which customers’ behavioral factors need to be considered. The research work in this thesis provides a methodical and technical framework to the study of hybrid appointment problems, and also lays a foundation to the extension and application of the related study.