A Multi-Server Queuing Model With Balking and Correlated Reneging With Application in Health Care Management

Queues or waiting lines are an integral part of health care facilities such as hospitals, outpatient clinics, medical laboratories, and many other health facilities. Health care management must have waiting lines control strategies for smooth functioning. Due to the lack of proper queuing control and management, patients may become dissatisfied and may leave (renege) the health care facilities without getting service. But, the reneging of patients at two consecutive time marks may be correlated in the sense that if a patient reneges at the current time mark, then there is a probability that a patient may or may not renege at the next time mark. This kind of reneging is referred to as correlated reneging. In this paper, we have introduced the concept of correlated reneging in a finite capacity multi-server queuing model with balking with its application in health care. The steady-state as well as the transient analyses of the model are carried out. We have also derived an expression for the correlation coefficient between the inter-reneging times and for the rate at which the health facility is losing patients (patient loss probability) due to insufficient capacity, reneging, and balking. We have provided numerical examples in order to demonstrate the effect of balking and correlated reneging on performance measures such as the mean number of patients waiting to be serviced, mean waiting time of patients, and the probability of patient rejection. Further, the effect of the number of servers on performance measures is investigated. Finally, the effect of the correlation coefficient between the inter-reneging times on performance measures is studied. The queuing model discussed in this paper could be useful to the health care firms facing the problem of patient impatience and capacity constraints.