Small Changes in Patient Arrival and Consultation Times Have Large Effects on Patients’ Waiting Times: Simulation Analyses for Primary Care

Matthias Grot, Simon Kugai (), Lukas Degen, Isabel Wiemer, Brigitte Werners and Birgitta M. Weltermann
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Matthias Grot: Institute of Management, Operations Research, Ruhr University Bochum, Universitätsstr. 150, 44801 Bochum, Germany
Simon Kugai: Institute for General Practice and Family Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
Lukas Degen: Institute for General Practice and Family Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
Isabel Wiemer: Institute of Management, Operations Research, Ruhr University Bochum, Universitätsstr. 150, 44801 Bochum, Germany
Brigitte Werners: Institute of Management, Operations Research, Ruhr University Bochum, Universitätsstr. 150, 44801 Bochum, Germany
Birgitta M. Weltermann: Institute for General Practice and Family Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany

IJERPH, 2023, vol. 20, issue 3, 1-11

Abstract: (1) Background: Workflows are a daily challenge in general practices. The desired smooth work processes and patient flows are not easy to achieve. This study uses an operational research approach to illustrate the general effects of patient arrival and consultation times on waiting times. (2) Methods: Stochastic simulations were used to model complex daily workflows of general practice. Following classical queuing models, patient arrivals, queuing discipline, and physician consultation times are three key factors influencing work processes. (3) Results: In the first scenario, with patients arriving every 7.6 min and random consultation times, the individual patients’ maximum waiting time increased to more than 200 min. The second scenario with random patient arrivals and random consultation times increased the average waiting time by up to 30 min compared to patients arriving on schedule. A busy morning session based on the second scenario was investigated to compare two alternative intervention strategies to reduce subsequent waiting times. Both could reduce waiting times by a multiple for each minute of reduced consultation time. (4) Conclusions: Aiming to improve family physicians’ awareness of strategies for improving workflows, this simulation study illustrates the effects of strategies that address consultation times and patient arrivals.

Keywords: general practice; appointment scheduling; consultation strategies; waiting times; stochastic discrete event simulation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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