Setting up waiting-time targets to satisfy patients: an application of mathematical programming

An out-patient-waiting-time standard has been set up by the government in the Patient's Charter and the standard is supposed to be effective nationwide indiscriminately. This standard is static and does not take into account local variations in patient expectations, patient unpunctualities in keeping their appointments, changing demand, and resource (or budget) constraints. Therefore, it is not surprising that many acute hospitals or Trusts (including the best-known teaching hospitals) have failed to achieve a satisfactory performance against this standard. In this paper, we argue that, while regarding this standard as the government's expectation, local out-patient-waiting-time targets could be set up more comprehensively each year on the basis of prevailing patient expectations, so that the most cost-effective (or optimal) quality is achieved instead of the ideal (or best) quality. We have also developed a mathematical-programming model which can be used to help determine the out-patient waiting-time targets in a systematic way, once the expected degrees of patient satisfaction are specified. A numerical example is provided to illustrate how the model works.