Effects of Rescheduling on Patient No-Show Behavior in Outpatient Clinics

Manufacturing & Service Operations Management (Forthcoming)

62 Pages Posted: 26 May 2016 Last revised: 20 Jul 2018

See all articles by Jiayi Liu

Jiayi Liu

University of Science and Technology of China (USTC) - School of Management

Jingui Xie

School of Management, University of Science and Technology of China

Kum Khiong Yang

Singapore Management University - Lee Kong Chian School of Business

Zhichao Zheng

Singapore Management University - Lee Kong Chian School of Business

Date Written: March 21, 2016

Abstract

We study the effects of rescheduling on no-show behavior in an outpatient appointment system for both new and follow-up patients. Previous literature has primarily focused on new patients and investigated the role of waiting time on no-show probability. We offer a more nuanced understanding of this costly phenomenon. Using comprehensive clinical data, we demonstrate that for follow-up patients, their no-show probability decreases by 10.9 percentage points if their appointments were rescheduled at their own request, but increases by 6.2 percentage points if they were rescheduled by the clinic. New patients, in contrast, are less sensitive to who initiates rescheduling. Their no-show probability decreases by 2.3 percentage points if their appointments were rescheduled at their own request, and increases by 3.2 percentage points --- but is statistically insignificant at the 10% level --- if they were rescheduled by the clinic. New patients are more concerned about waiting time compared to follow-up patients. For patients whose appointments were not rescheduled, new patients' no show probability decreases by 1.3 percentage points if their waiting time is reduced by one week, but the waiting time has a small and statistically insignificant effect on follow-up patients' no show probability. Using data-driven simulation, we conduct counterfactual investigation of the impact of allowing active rescheduling on the performance of appointment systems. In particular, allowing the flexibility of patient rescheduling can reduce the overall no-show rate and increase system utilization, but at a cost of increased wait time for new patients. If patients are able to reschedule at least one week in advance, new patients' wait time is largely reduced, while the no-show rate remains the same; this is equivalent to the effect of a 5% increase in clinic's capacity.

Keywords: Appointment Scheduling; Rescheduling; No-Show; Econometrics; Data-Driven Simulation

Suggested Citation

Liu, Jiayi and Xie, Jingui and Yang, Kum Khiong and Zheng, Zhichao, Effects of Rescheduling on Patient No-Show Behavior in Outpatient Clinics (March 21, 2016). Manufacturing & Service Operations Management (Forthcoming), Available at SSRN: https://ssrn.com/abstract=2783646 or http://dx.doi.org/10.2139/ssrn.2783646

Jiayi Liu

University of Science and Technology of China (USTC) - School of Management ( email )

China

Jingui Xie

School of Management, University of Science and Technology of China ( email )

Jinzhai Road No. 96
HEFEI, Anhui 230026
China
86(551)63606983 (Phone)

Kum Khiong Yang

Singapore Management University - Lee Kong Chian School of Business ( email )

469 Bukit Timah Road
Singapore 912409
Singapore

Zhichao Zheng (Contact Author)

Singapore Management University - Lee Kong Chian School of Business ( email )

50 Stamford Road
Singapore, 178899
Singapore
(65) 6808 5474 (Phone)
(65) 6828 0777 (Fax)

HOME PAGE: http://www.zhengzhichao.com

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