Appointment Scheduling Considering Outpatient Unpunctuality Under Telemedicine Services

Patient unpunctuality substantially complicates appointment scheduling in integrated telemedicine–traditional outpatient systems. The current research frequently ignores behavioral distinctions between telemedicine patients and outpatients, while neglecting to measure the intangible burden on physic...

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Bibliographic Details
Published in:Mathematics (Basel) Vol. 13; no. 16; p. 2591
Main Authors: Chen, Wei, Chen, Liang, Shen, Xiaoxiao, Zhang, Yutao, Wang, Xiulai
Format: Journal Article
Language:English
Published: Basel MDPI AG 01.08.2025
Subjects:
Behavior
Costs
Efficiency
Fines & penalties
Heterogeneity
Integer programming
Linear programming
Mathematical programming
Medical appointments and schedules
Methods
Mixed integer
Optimization
outpatient appointment scheduling
Patients
Physicians
Schedules
Scheduling
Sensitivity analysis
service switching
Stochastic models
stochastic optimization
Switches
Systems stability
Telemedicine
China
ISSN:2227-7390, 2227-7390
Online Access:Get full text
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Summary:Patient unpunctuality substantially complicates appointment scheduling in integrated telemedicine–traditional outpatient systems. The current research frequently ignores behavioral distinctions between telemedicine patients and outpatients, while neglecting to measure the intangible burden on physicians from service mode switches. To address these gaps, this study incorporates patient heterogeneity and introduces two novel cost metrics. Specifically, we implement penalties for service-mode switching and penalties for consecutive telemedicine sessions. We develop a Stochastic Mixed-Integer Programming (SMIP) model. This stochastic model is transformed into a deterministic Mixed-Integer Linear Programming (MILP) formulation via Sample Average Approximation (SAA). Linearization techniques enhance computational efficiency. In numerical experiments, the dual-penalty model yields balanced schedules with moderate patient mix, reducing physician overtime by 62.5% and service mode switches by 55% compared to baseline approaches. Sensitivity analysis confirms that narrowing outpatient unpunctuality ranges significantly reduces patient waiting and overtime, while raising telemedicine patient proportions bolsters system stability at the cost of increased physician idle time. These insights offer actionable guidance for healthcare institutions managing integrated online–offline services.
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ISSN:2227-7390
2227-7390
DOI:10.3390/math13162591