Browsing by Author "Tagimacruz, Maria Antonieta"
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Item Open Access Queueing analysis of two healthcare systems where physician activity is offloaded to supporting health professionals(2020-06-30) Tagimacruz, Maria Antonieta; Bischak, Diane P.; Marshall, Deborah A.; Bijvank, Marco; Brennan, Robert William; da Silveira, Giovani J. C.; Willoughby, K. A.Patient waiting time to see a specialist and specialist utilization are vital aspects of providing musculoskeletal (MSK) healthcare service. Long waiting times not only subject patients to physical pain and suffering but also detrimentally impacts society. This dissertation uses queuing theory to analyze three models for rheumatologists consultation involving an alternative care provider, osteoarthritis consultation involving a musculoskeletal screener, and a central intake referral system for osteoarthritis patients. The second chapter presents a queueing and simulation approach to analyze the impact of an alternative care provider in a rheumatologist consultation system on waiting time and specialist utilization. Using a multi-class closed queueing network, we look into the boundaries for workload allocation within which performance improvements are realized. Chapter three compares an osteoarthritis consultation system with and without an MSK screener modeled as a network of queues. In addition to the impact of the addition of the MSK screener, we also investigate the impact of the surgical threshold of the screener relative to that of the surgeon to the patient waiting time and surgeon’s utilization. Finally, in the fourth chapter, we model an osteoarthritis referral central intake system and explore the impact of the deterministic and probabilistic routing decisions at the central intake on surgical patient waiting time and surgeon’s utilization.