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Decision Analysis: Use of Queuing Models in Health Care

Queuing theory and analysis can be used in healthcare settings to model patient wait times and optimize resource allocation. This document provides an overview of using queuing models for various areas of healthcare like emergency rooms, clinics, and pharmacies. It also describes key characteristics of queuing systems like arrival and service patterns. An example analysis of a diabetes clinic shows that having 3 nurses minimizes total costs from wait times and staffing while keeping the system utilization optimal. However, queuing models make assumptions that limit their accuracy for long-term planning.

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49 views

Decision Analysis: Use of Queuing Models in Health Care

Queuing theory and analysis can be used in healthcare settings to model patient wait times and optimize resource allocation. This document provides an overview of using queuing models for various areas of healthcare like emergency rooms, clinics, and pharmacies. It also describes key characteristics of queuing systems like arrival and service patterns. An example analysis of a diabetes clinic shows that having 3 nurses minimizes total costs from wait times and staffing while keeping the system utilization optimal. However, queuing models make assumptions that limit their accuracy for long-term planning.

Uploaded by

dnrajasthan
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Use of Queuing

Decision
Models in
Analysis
Health Care
Queuing
Theory

“ .. Is the mathematical approach to the


analysis of waiting lines in healthcare
settings…”

Most of healthcare systems have excess


capacity to accommodate random
variations, so queuing analysis can be
used as:
Short term measure, or
For facilities and resource
planning
Uses of
simulation
Queuing
inanalysis
healthcare
and

 Walk in patients in clinics


 Emergency room arrivals
 Phone calls from physician offices to HMO
 Outpatient clinics and outpatient surgeries
 Physician offices
 Pharmacy
 Inventory Control
 Healthcare resource and infrastructure
planning for disaster management
 Public health, etc..
Costs of
waiting lines or
queue

 Cost associated with patients having

to wait for service

 Loss of business to HCO

 Costs incurred by society

 Decreased patient satisfaction


Cont..

Capacity costs: costs of maintaining


the ability to provide service
 Salaries paid to employees/servers
while they wait for service from
other server
Fixed costs - Cost of waiting space,
facility, equipment and supplies
Health Care
Service Capacity
and Costs

If the organization decides to increase the level of service provided, cost of


providing services would increase, if it decides to limit the same, costs associated
with waiting for the services would increase. So the manager has to balance the
two costs and make a decision about the provision of optimum level of service, the
lowest point in total cost curve in the diagram, which is frequently guided by the
policies of the organization.
Queuing System
Characteristics

 Population Source:
Infinite Source
Finite Source
 Number of Servers:
Capacity of each server (channel)
Number of servers
 Arrival Pattern: Poisson distribution
or negative exponential distribution
 Service Patterns: service time and rate
 Queue Discipline: first come first
serve, urgency, appointment, etc..
BASICS OF
QUEUING
THEORY

Setting Input process Out process


Hospital Arrival of the patient at the Assessment, triage,
registration counter provision of services,
discharge

PCP Office Arrival at registration Assessment by PCP,


counter or front office desk prescription and tests, and
collection of bills at the exit

ER Ambulance arrival Assessment, triage,


assessment, triage to the
inpatient setting or
discharge after treatment
Types of
queuing
systems

It can be
single line-single phase

single line-multiple phase

multiple line-single phase or

multiple line-multiple phase service


Cont..

single line-single phase

Single-line, multi-phase system


Cont..

multiple line-single phase


or

multiple line-multiple phase service


Measures of
Queuing System
Performance

 Average number of patients waiting


(in queue or in system)
 Average waiting time
Capacity utilization
 Cost of given level of capacity
 Probability that an arriving patient
will have to wait and for how long
Queue
process
Diabetes
Patients
Example

Single server: arrival rate – 4 pts/hr

Service rate – 5pts/hr

Multiple server: arrival rate – 9 pts/hr

service rate –5pts/hr

operational cost-$40/hr

waiting cost -$75/hr


Cont..
Inputs:

Parameter Value Value Value


M/M/s

Arrival
rate(lambda) 9 9 9

Service rate(mu) 5 5 5

Number of
Servers 2 3 4

Server cost
Rs/time 40 40 40

Waiting cost
Rs/time 75 75 75
Results:

Value
Parameter
2 3 4
Nurses Nurses Nurses

Average server utilization 0.9 0.6 0.45

Average number in the queue(Lq) 7.67 0.53 0.11

Average number in the system(Ls) 9.47 2.33 1.91

Average time in the queue(Wq) 0.85 0.06 0.01

Average time in the system(Ws) 1.05 0.26 0.21

Cost (Labor + # waiting*wait cost) 655.5 159.91 167.89

Cost (Labor + # in system*wait


cost) 790.53 294.91 302.89
Sensitivit
y Analysis

Performance measure 2 Nurses 3 Nurses 4 Nurses

Pt. arrival rate 9 9 9


Service rate 5 5 5
Overall system utilization 90% 60% 45%

L (system 9.5 2.3 1.9


Average number in the queue(Lq) 7.7 0.5 0.1

Average time in the system(Ws) 1.05 0.26 0.21


Average time in the queue(Wq 0.85 0.06 0.01
Probability of zero units in the system 5.30% 14.60% 16.20
(Po) idle
Probability of n units in the system 85.30% 35.50% 12.80%
(Pw) busy

Total system cost in $ per hour 790.53 294.91 302.89


Interpretatio
n of results:

We can interpret from the sensitivity analysis that it


would be most efficient to have three booths with three
nurse, which not only minimizes the total cost incurred
but also minimizes the waiting costs. So the option of
three booths with three nurse is an optimal solution with
optimum tradeoff between the two types of cost
involved in queuing models.
Limitatio
ns

Takes average of all variables


 Based on assumption that service time is known
 Service times are independent from one another
 Service rate is known
 Service rate is greater than arrival rate
 Arrivals are served on first come first serve basis
 Service times are described by the negative
exponential probability distribution
 Used for short term phenomenon and is
deterministic
Thank You

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