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Comparison of Gatekeeping and Non-gatekeeping Designs in a Service System with Delay-sensitive Customers

Journal of Systems Science and Systems Engineering 2021年第2期30卷 125-150页

作者： Wenhul Zhou Xiuzhang Li Qu Qian School of Business Administration South China University of TechnologyGuangzhou 510641China School of Business Singapore University of Social SciencesSingapore 599494Singapore

This paper is motivated by a concern in China's current medical practice in which patients can bypass the primary care and seek secondary care *** employ a queueing approach to examine two settings,*** gatekeeping and non-gatekeeping settings,in a service system consisting of two types of service provider-one with basic skills(C-H),*** hospital,and the other with advanced skills(AAA-H),*** *** are heterogeneous with respect to service *** C-H can only serve customers with a complexity level of service requirement lower than the cure threshold,while the AAA-H can serve all *** aim to analyze the social planner's capacity decision for the C-H in both settings and assess the relative merit of each setting with respect to total social welfare,*** sum of customer benefits net of customer delay costs and service providers7 operating *** findings show that when the C-H's capacity is exogenous,the gatekeeper setting is preferable if the capacity of the C-H is in the intermediate range because customers'self-selection behavior gives rise to negative *** the C-H's capacity is optimized by the social planner,the non-gatekeeping setting is preferable if the capacity of the AAA-H is large or the cure threshold is high,because customers'self-selection behavior as well as the investment in the C-H's capacity can result in a better distribution of demand among the two service *** gatekeeping setting is preferable if the cure threshold is low because it is economical for the social planner to invest in a large capacity in the C-H to serve all *** also show numerically the conditions under which the two settings can achieve the first-best solution.

关键词： Customer delay sensitivity gatekeeper service capacity cure fraction total social cost

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