Question

Ocean City is a vacation beach community one mile long, with all of its 1,000 daily vacationers evenly distributed along the beach and boardwalk. At each end of the boardwalk is an urgent care clinic specializing in the treatment of jellyfish stings. The clinic on the south end of the boardwalk is Clinic S and the one on the north end of the boardwalk is Clinic N. On any given day, there is a 10% chance of being stung by a jellyfish. Due to the hot sand and the congested boardwalk, each vacationer’s travel cost of going to a clinic after a jellyfish sting is $20 per mile. However, this is preferable to the excruciating pain of non-treatment, so all who are stung go to one clinic or another for treatment. (Assume that, once stung, a person does not go back into the water, so that each person can only be stung once at most.) Finally, assume that each clinic’s marginal cost of treating each sting is a constant $8 per sting. 3.A (10) What is the expected demand for each clinic as a function of its price and the other clinic’s price? (Make sure to show all of your work in deriving these demands.)

3A is the question number.

Answer 1

More than 25 000 appointments were analysed. The 6‐step method showed to be sufficient to result in valuable insights and leads for improvement. While the overall match between demand and capacity was considered adequate, the variability in capacity was much higher than in demand, thereby leading to delays in access time. Holidays and subsequent weeks showed to be of great influence for demand, capacity, and access time. Using the six‐step method, several unfavourable characteristics of the outpatient clinic were revealed and a better match between demand, supply, and access time could have been reached with only minor adjustments. Last, a clinic specific prediction and decision model for demand and capacity was made using the 6‐step method.

Accessibility to care providers is one of the main challenges that every specialist outpatient clinic has to deal with. Delays in access time are nowadays such a common phenomenon that it seems to be considered as an inevitable burden by the public . This acceptation could be a dangerous development; delays in access time are not only unpleasant but also increase the burden to sick or discomforted people and could even become dangerous in the case of (unnoticed) medical urgencies. This makes accessibility a vital aspect of health care in the pursuit of delivering the best clinical care possible .

From a logistical point of view, waiting is sometimes considered as unavoidable due to the constraints on capacity.However, seen from other perspectives, the inevitableness of delays in access time is not always shared. A common and frequently used perspective is the regular system perspective of access time.n this perspective, delays are explained as a mismatch between supply and demand. Supply—or capacity leading to the supply—can be seen as the specialist delivering care, while demand is the number of patients requesting for an appointment. his includes demand that is generated by the specialist scheduling future follow‐up appointments. In the most optimal scenario, demand and supply are always synchronized with each other so that no delay in access time nor waste of capacity exists. Unfortunately, demand and supply have always a certain degree of variability and stochasticity. This means that even if they are on average equal but without synchronicity, waiting and utilization will be observed'

In the logistical struggle of daily outpatient practice, policy makers sometimes try to “solve” delays in access time by manipulating demand and supply, such as discouraging demand for new consultations or stretching up the stake of available capacity by forcing health providers to treat more patients with the same resources. Nonetheless, these measures do not offer a sustainable solution .

However, studies using the concepts of “push” and “pull” logistics to analyse demand, supply, and access time in the outpatient clinic are very sparse.7 This is regrettable, as evidence‐based studies could give outpatient clinics valuable insights to analyse and optimize their own outpatient logistics. Moreover, studies based on daily outpatient practice could support existing theoretical hypotheses and direct future research of “push” and “pull” logistics.