Physician and Patient Behavior under Different Scheduling Systems in a Hospital Outpatient Department

Most research in the field of scheduling of ambulatory patients has defined outpatient appointment systems along a patient-arrival spacing dimension. Along this dimension, scheduling methods have ranged from pure block systems (in which all patients are asked to arrive before the start of the clinic) to individual appointment-time systems (in which patients are given appointments at intervals which approximate average physician service time). Four factors—type of scheduling system utilized, amount of physician lateness, amount of patient lateness, and patient no-show rate—have been shown to affect patient waiting time strongly. A study performed in the Combined Clinics of the Massachusetts General Hospital and the Massachusetts Eye and Ear Infirmary provides two additional findings with regard to the ambulatory scheduling process. First, the assignment at the time of appointment of a patient to a specific physician is another significant element in the design and the effectiveness of appointment systems. Second, with the addition of the assignment variable in system definition, a striking behavior pattern was found. The no-show rate, patient arrival time, physician arrival time, and patient waiting time all changed in concert from one appointment system to another among three major systems studied. All factors were found to favor the expeditious delivery of patient care by systems which treated the patient as an individual, in comparison with those that implicitly regarded him as an anonymous figure seeing an unidentified physician

Ambulatory · Ambulatory care · Arrival time · Health care · Medical emergency · Operations management · Outpatient clinic · Scheduling (production processes) · Engineering · Healthcare Operations and Scheduling Optimization · Hospital Admissions and Outcomes · Medicine · Patient Satisfaction in Healthcare

• Selecting a Suitable Appointment System in an Outpatient Setting

  J Vissers, Joseph H A Vissers•Medical Care•1979

  Incluir item

• A Predictive Model for Ambulatory Patient Service Time

  John F Rockhart, Eric L Herzog•Medical Care•1974

  Incluir item

• Appointment-Breaking in a General Medical Clinic

  Steven Jonas•Medical Care•1971

  Incluir item

• The Determinants of Dropping Out of Care Among Hypertensive Patients Receiving a Behavioral Intervention

  David Strogatz, David S Strogatz et al.•Medical Care•1983

  Incluir item

• Unscheduled Use of Ambulatory Care Services

  Arnold V Hurtado, Donald K Freeborn et al.•Medical Care•1974

  Incluir item

• Dropouts and Broken Appointments

  Richard A Deyo, Thomas S Inui•Medical Care•1980

  Incluir item

• Influence of the Weather on Appointment-breaking in a General Medical Clinic

  Steven Jonas•Medical Care•1973

  Incluir item

• Patient Participation in the Patient-Provider Interaction

  Open Access•Debra L Roter, Debra Roter•Health Education Monographs•1977

  Incluir item

• Appointment-keeping behavior re-evaluated

  P Hertz, Rosa Olivares et al.•American Journal of Public Health•1977

  Incluir item

• The diagnosis and management of the walk-in syndrome

  Dorothy S Lane•American Journal of Public Health•1974

  Incluir item

• Appointment Systems in Out-patients?? Clinics and the Effect of Patients?? Unpunctuality

  M J Blanco White, Malcolm C Pike•Medical Care•1964

  Incluir item