Managing Outpatient Service with Strategic Walk-ins
Bibliographic record
Abstract
Outpatient care providers usually allow patients to access service via scheduling appointments or direct walk-in. Patients choose strategically between these two access channels (and otherwise balking) based on the trade-off of appointment delay and in-clinic waiting. How to manage outpatient care with such dual access channels, taking into account patient strategic choice behavior, is a challenge faced by providers. We study three operational levers to address this management challenge: service capacity allocation between these two channels, appointment delay information revelation via the choice and design of online scheduling systems, and a walk-in triage system that restricts the use of walk-in hours only for acute care. By studying a stylized queueing model, we find that neither a real-time online scheduling system (which offers instant access to appointment delay information at time of booking) nor an asynchronous online system (which does not directly provide delay information) can be universally more efficient. Although real-time systems appear more popular in practice, asynchronous systems sometimes can result in higher operational efficiency. Under the provider’s optimal capacity allocation, which scheduling system is more efficient hinges on two key factors: the patient demand–provider capacity relationship and patient willingness to wait. For the walk-in triage system, we find that it may or may not be beneficial to adopt; the provider’s own cost trade-off between lost demand and overtime work is the key determinant. Our research highlights that there is no one-size-fits-all model for outpatient care management, and the best use of operational levers critically depends on the practice environment. This paper was accepted by Jayashankar Swaminathan, operations management. Funding: S. Wang’s work was supported in part by the National Natural Science Foundation of China [Grants 72001220 and 71931008]. Supplemental Material: The online appendix is available at https://doi.org/10.1287/mnsc.2023.4676 .
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".