Early Reservation for Follow-up Appointments: Enhancing Patient Care Continuity

Problem definition: In the context of outpatient care, physicians often decide at the end of a consultation session whether to schedule follow-up appointments for patients with likely future needs. Those appointments are referred to as prioritized follow-up (PFU) appointments. We study mechanisms that encourage physicians to schedule the optimal quantity of PFUs, aiming to enhance continuity of care (COC), minimizing no-shows and late cancellations. Methodology/results: Utilizing both empirical analysis and modeling, this paper examines strategies for enhancing COC within an appointment scheduling framework. It presents empirical evidence indicating that a greater frequency of PFUs is associated with improved COC. Subsequently, a queueing model is introduced that delineates the impact of PFU appointments on revenue generation and COC levels. The model reveals a discrepancy between physician and health system preferences regarding the number of PFUs with doctors inclined to schedule fewer and health systems favoring more. We apply a principal–agent model to examine the optimal decisions of both the clinic (principal) and the doctor (agent). For situations involving symmetric information, we identify a performance-based payment structure that effectively aligns the incentives of both stakeholders. When information is asymmetric, we theoretically compare four distinct contract types and identify the most promising candidate. Managerial implications: Our findings suggest that health systems ought to implement incentive schemes that reward physicians for a higher proportion of PFUs in their appointment schedules. Such rewards are more cost-effective than those based on the aggregate number of PFU appointments.

History: This paper was selected as part of the 1RR initiative between the M&SOM journal and the MSOM Society. This paper was part of the 2024 MSOM Service Operations SIG Conference.

Funding: This research was supported by the National Natural Science Foundation of China [Grants 72471244 and 72101102], the Natural Science Foundation of Hunan Province [Grant 2024JJ6536], and the Natural Sciences and Engineering Research Council of Canada [Grants RGPIN-2025-05592 and RGPIN-2019-05539].

Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2025.0321.