Tactical allocation and acceptance of multiple patient classes in the presence of no-shows

Abstract

Clinics that provide pediatric care are frequently confronted with family group appointment requests, where parents desire their children to be scheduled simultaneously or consecutively. This is potentially beneficial to the family by minimizing the number of trips to the provider's office. However, offering prescheduled group appointments have the risk of reducing provider utilization, particularly if the entire group fails to meet their scheduled appointment. Similarly, reserving appointment slots for same day group appointment requests may also decrease utilization and impact profitability. This paper explores the impact of family group appointments on clinic performance in terms of provider utilization and profit. A finite-horizon, stochastic dynamic programming problem is presented to determine the optimal scheduling strategy given both individual and group appointment requests can be tactically accommodated via overbooking. On the basis of a computational study, we quantify the risk to clinic profitability and productivity resulting from the no-show behavior of prescheduled appointments. We also characterize the behavior of the optimal scheduling strategy as a function of prescheduled appointment allocations among the patient classes.