1*Principal, College of Hospital Administration, Dr. Somervell Memorial CSI Medical College and Hospital, Karakonam, Kerala, India
2Assistant Professor, MBA Department, Annai Vailankanni College of Engineering, Azhagappapuram, Tamilnadu, India
3,4,5,6IInd MHA Students, College of Hospital Administration, Dr. Somervell Memorial CSI Medical College and Hospital, Karakonam, Kerala, India
Waiting time is a critical indicator of healthcare operational performance and patient-centered service quality. Although outpatient pharmacies represent the final service node in the care continuum, systematic quantitative evaluation of congestion dynamics remains limited in tertiary care settings in India. This study integrates analytical queuing theory, discrete-event simulation (DES), and cost-effectiveness analysis (CEA) to evaluate waiting time performance in the outpatient pharmacy of a tertiary care teaching hospital in Kerala. Empirical time–motion observations (N = 1,584 encounters) were conducted to estimate arrival and service parameters. The system was modelled as an M/M/4 queue under first-come-first-served discipline and validated using 100 simulation replications. Statistical comparison across three scenarios—baseline (four counters), temporary peak-hour expansion (five counters), and staff redeployment—revealed significant reductions in mean waiting time, F(2, 297) = 184.63, p < .001, η² = .55. Incremental cost-effectiveness analysis demonstrated superior efficiency of peak-hour expansion (Rs.187 per patient-hour saved) compared to permanent staffing expansion (Rs.349 per hour). Findings support demand-responsive staffing strategies and demonstrate the value of integrating operational analytics with economic evaluation in hospital management.
Keywords: queuing theory, discrete-event simulation, outpatient pharmacy, waiting time, healthcare operations, cost-effectiveness.
How to cite this article: Jeyarajasekar T, Mathias R, Erick M, Varsha SB, Abisha C, Ardra MS. Optimizing Outpatient Pharmacy Waiting Time through Integrated Queuing Theory, Discrete-Event Simulation, and Cost-Effectiveness Analysis: Evidence from a Tertiary Care Teaching Hospital in India. Int J Drug Deliv Technol. 2026; 16(8s): 490-503; DOI: 10.25258/ijddt.16.8s.61
Source of support: Nil.
Conflict of interest: None