Ein Operations-Research-Ansatz zur Bestimmung von Standorten und Einzugsbereichen von Krankenversorgungsbetrieben

Abstract

Eingegangen am24. Januar 1975Zusammenfassung: In der vorliegenden Arbeit werden Modelle sowohl fiir den Bereich der ambulanten als auch der station/iren Krankenversorgung entwickelt. Diese beiden Teilprobleme erfordern jeweils ein Modell, das das Verteilungsverhalten der Patienten auf die Standorte der Versorgungsinstitutionen erkl/irt, sowie eines zur Bestimmung der optimalen Standorte von Arztpraxen bzw. Krankenh~iusern, wobei allerdings eine Rfickkoppelung zum Verteilungsmodell beachtet werden muB. Die zur LSsung dieser speziellen, teils in hohem MaBe nichtlinearen Probleme entwickelten N/iherungsalgorithmen werden in ihren Grundzfigen erl/iutert. AbschlieBend wird ein kurzer Oberblick fiber die praktischen Ergebnisse gegeben, die die Modelle bei Anwendung auf ein konkretes Gebiet in Sfiddeutschland geliefert haben. Summary:The Problem of health-service consists of two components: the ambulatory treatment by practicing physicians and the treatment in hospitals. For the two problems models are developed, which determine both the allocation of patients to the above health-care institutions and the optimal number and locations of these institutions. As exact algorithms cannot be used because of the nonlinearity or the great number of variables the developed approximation algorithms are roughly explained. Finally some practical results of the application of the models to a testregion in southern Germany are submitted.

Social Optimal Location of Facilities with Fixed Servers, Stochastic Demand, and Congestion

“…We believe that this assumption is typically not appropriate for fixed server models, where customers travel to facilities. When users choose facilities, Heinhold (1975Heinhold ( , 1978 and Grossman and Brandeau (2002) argue that customers will make their choice based on both travel time to a facility and expected waiting time at the facility. Heinhold (1975Heinhold ( , 1978 report on empirical studies of vehicle inspection stations and health clinics whose results were consistent with each user choosing a facility to minimize the sum of her travel and waiting times.…”

“…When users choose facilities, Heinhold (1975Heinhold ( , 1978 and Grossman and Brandeau (2002) argue that customers will make their choice based on both travel time to a facility and expected waiting time at the facility. Heinhold (1975Heinhold ( , 1978 report on empirical studies of vehicle inspection stations and health clinics whose results were consistent with each user choosing a facility to minimize the sum of her travel and waiting times. Consequently, a user may choose not to travel to the closest facility but to one that is further away and less congested.…”