Effect of two-level provider capacities on the performance of open access clinics

The successful implementation of open access scheduling requires the match of daily healthcare provider capacity and patient demand at the high level of total capacity and the low levels of individual capacities for different types of appointments. In this paper, we introduce 12 scheduling rules for determining the two-level provider capacities and compare them in terms of four performance metrics: the probabilities of granting requests for fixed and open appointments, and the expectation and the variance of the number of patients consulted. Our analytical results show that adjusting low level provider capacities can reduce the difference between the two probabilities. When the ratios of low level capacities to the high level provider capacity are fixed, the two probabilities increase with the increase in the high level capacity. Meanwhile, our numerical results demonstrate that the expectation and the variance of the number of patients consulted increase with the increase in the high level capacity. The results provide insights in determining optimal two-level provider capacities to match daily patient demand. Potential approaches to optimality are also proposed based on the results. © 2008 Springer Science+Business Media, LLC.