Queuing network models for panel sizing in oncology

Motivated by practices and issues at the British Columbia Cancer Agency (BCCA), we develop queuing network models to determine the appropriate number of patients to be managed by a single physician. This is often referred to as a physician’s panel size. The key features that distinguish our study of oncology practices from other panel size models are high patient turnover rates, multiple patient and appointment types, and follow-up care. The paper develops stationary and non-stationary queuing network models corresponding to stabilized and developing practices, respectively. These models are used to determine new patient arrival rates that ensure practices operate within certain performance thresholds. Data from the BCCA are used to calibrate and illustrate the implications of these models.