Off-campus UMass Amherst users: To download campus access theses, please use the following link to log into our proxy server with your UMass Amherst user name and password.

Non-UMass Amherst users: Please talk to your librarian about requesting this thesis through interlibrary loan.

Theses that have an embargo placed on them will not be available to anyone until the embargo expires.

Document Type

Open Access

Degree Program

Industrial Engineering & Operations Research

Degree Type

Master of Science in Industrial Engineering and Operations Research (M.S.I.E.O.R.)

Year Degree Awarded

2010

Month Degree Awarded

September

Keywords

Flexibility, Capacity Allocation, Performance, Primary Care

Abstract

The two important metrics for any primary care practice are: (1) Timely Access and (2) Patient-physician Continuity. Timely access focuses on the ability of a patient to get access to a physician as soon as possible. Patient-physician continuity refers to building a strong or permanent relationship between a patient and a specific physician by maximizing patient visits to that physician. In the past decade, a new paradigm called advanced access or open access has been adopted by practices nationwide to encourage physician to “do today’s work today.” However, most clinics still reserve pre-scheduled appointments for long lead-time appointments due to patient preference and clinical necessities. Therefore, an important problem for clinics is how to optimally manage and allocate limited physician capacities as much as possible to meet the two types of demand – pre-scheduled (non-urgent) and open access (urgent) – while simultaneously maximizing timely access and patient-physician continuity. In this study we use a quantitative approach to apply the ideas of manufacturing process flexibility to capacity management in a primary care practice. We develop a closed form expression for capacity allocation for an individual physician and a two physician practice. In the case of multiple physicians, we use a two-stage stochastic integer programming approach to investigate the value of flexibility under different levels of flexibility and provide the optimal capacity allocation solution for each physician. We find that flexibility has the greatest benefit when system utilization is balanced and when the individual physicians have unequal utilizations. The benefits of flexibility also increase as the practice gets larger.

First Advisor

Hari J. Balasubramanian

Second Advisor

Ana Muriel

Share

COinS