Stochastic Appointment Scheduling with Patient-and-Time-Dependent Probability Distributions

Abstract

Outpatient appointment scheduling must balance provider idle time, overtime, and patient waiting under uncertain service times, punctuality, and attendance. These factors may follow patient-and-time-dependent probability distributions, which existing models rarely incorporate simultaneously because of modeling and computational complexity. We propose a stochastic programming model that captures exponentially many scenarios with polynomially many variables and constraints, without sampling. It accommodates patient-dependent service times and patient-and-time-dependent no-shows and arrival times. We also discuss estimating these distributions from electronic health records. We examine how personalized reminders and changes in attendance due to incentives or negative clinic experiences affect scheduling. Our model optimally solves instances of up to 14 patients in reasonable computational time. Its schedules outperform classical Bailey-type rules. Even the best-performing variant has 97% higher expected cost on average. Incorporating patient-dependent service times reduces total costs by 34% on average. Accounting for patient-and-time-dependent unpunctuality and no-shows reduces costs by 12% and 67%, respectively. Personalized reminders can reduce costs by 23%, and sensitivity analyses show that these gains withstand moderate errors in estimated distributions. These findings show how modeling individual patient behavior and tailoring communication can reduce waiting, idle time, and overtime.