Optimal Physician Scheduling in a Multi-Clinic Network to Improve Patient Accessibility to Outpatient Care

摘要

Cost containment and workforce utilization typically leads to healthcare access regionalization. Little attention has thus been given to patient's spatial accessibility in appointment scheduling. As a result, many outpatients encounter huge travel burden, especially when the service items are routine. We in this research consider a multi-clinic network. In the current practice, outpatient visits are scheduled in large medical centers, which may be far away from the patients' residences. We propose to schedule physicians' weekly visits to local clinics and formulate the optimal physician scheduling decision problem as an integer program. Our aim is to minimize patient travel distance and time. We apply a simulation optimization approach to incorporate spatial uncertainties in follow-up visit requests. We present numerical studies to prove the concept that there is a need for the development of new delivery systems as many routine procedures can be done closer to patients' residences.