INTERNATIONAL JOURNAL OF LATEST TECHNOLOGY IN ENGINEERING,
MANAGEMENT & APPLIED SCIENCE (IJLTEMAS)
ISSN 2278-2540 | DOI: 10.51583/IJLTEMAS | Volume XIV, Issue XII, December 2025
waiting time, queue length, and server utilization. Such measures are essential for identifying bottlenecks and
evaluating alternative service policies.
In Indian government hospitals, patient arrivals are often unpredictable and highly variable across different times
of the day. Emergency cases, walk-in patients, and referral cases further complicate the service structure. Despite
these challenges, limited studies have focused on quantitatively analyzing patient flow in Indian public hospitals
using queueing theory. Most existing studies emphasize qualitative assessments or isolated performance
indicators, leaving a gap in systematic, model-based analysis tailored to the Indian healthcare environment.
The present study addresses this gap by applying queueing theory to analyze patient flow in selected government
hospitals in India. The study models outpatient and emergency services using appropriate single-server and
multi-server queueing systems to evaluate operational performance under real-world constraints. The objective
is to quantify congestion levels, assess resource utilization, and examine the impact of staffing configurations
on patient waiting times. The findings aim to provide practical insights that can assist hospital administrators
and policymakers in improving service efficiency without significant additional investment.
LITERATURE REVIEW
Global Studies on Queueing Theory in Healthcare
Queueing theory has been widely used in healthcare operations research to analyze patient flow and improve
service efficiency. One of the earliest applications in healthcare was by Green (2006), who examined outpatient
clinic operations to estimate waiting times and optimize staffing levels using stochastic models. By modeling
patient arrivals with Poisson processes and varying service rates, the study demonstrated significant
improvements in operational performance when queueing models were integrated into scheduling decisions.
Mak and Bates (2009) applied priority queueing systems to emergency departments, recognizing that
heterogeneous patient classes, such as critical and non-critical cases, require different service policies. Their
model accounted for prioritization and showed that adopting priority discipline can reduce waiting times for
urgent cases, albeit with trade-offs in overall system congestion. Similarly, Kim et al. (2018) used multi-server
queueing models to optimize resource allocation in surgical units, highlighting how operations research
techniques reduce bottlenecks and enhance throughput.
Simulation-based queueing approaches were explored by Jun et al. (1999), who combined discrete event
simulation with queueing models to evaluate alternative clinic designs. This hybrid methodology provided a
comprehensive view of dynamic patient flow, capturing variability that analytical models alone may overlook.
Lundgren and Jansson (2017) applied Markovian models to assess patient waiting times in radiology
departments, demonstrating the applicability of queueing theory in diagnostic service units.
These global studies establish that queueing theory is an effective analytical tool for investigating healthcare
systems, offering quantitative insights for decision support. However, the adoption and real-world
implementation of these models vary across regions, depending on data availability and organizational readiness.
Studies in the Indian Healthcare Context
In India, healthcare facilities often operate under constraints distinct from developed economies, such as higher
patient volumes, limited infrastructure, and diverse patient needs. Despite these unique challenges, research
applying queueing models in Indian hospitals is growing, though still limited.
Sharma and Gupta (2014) analyzed outpatient department operations in a tertiary government hospital in
Northern India using an M/M/1 queueing model. Their study revealed that peak-hour arrivals significantly
increased waiting times, suggesting that incremental staff allocation could achieve better service levels.
Similarly, Patel et al. (2017) investigated patient waiting patterns in a public hospital’s radiology unit, employing
M/M/s models to estimate service performance. They concluded that multi-server configurations with staggered
shifts reduced average waiting times.
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