Modelo não linear de localização de instalações de serviços de saúde com indicador de acessibilidade incorporado

Abstract

The study proposes a differentiated approach to the localization of public services (unlike methods focusing solely on locational efficiency in the distribution of such services), with a nonlinear model that incorporates an accessibility indicator and allows rejecting solutions in which accessibility fails to comply with acceptably established minimum parameters. The method aims to minimize the total time spent by a region's population to reach a public services network, while controlling the range between the highest and lowest accessibility to the services. The resulting solution is not as efficient as other models (e.g., p-median) in relation to total cost for the population as a whole to access the system, but it seeks to prevent the most distant areas from experiencing greater difficulty due to their disproportional traveling time. The model was tested in a region in the hospital network of the State of Santa Catarina, Brazil, and the results show that incorporation of the indicator suggests improvement when compared to the current distribution of hospitals in that area. The proposed methodology can be a useful tool for planning balanced resource allocation during installation of health services for the population.

Hospitais gerais: inserção nas redes de atenção à saúde e fatores condicionantes de sua atuação

“…Cirino et al 25 trazem uma reflexão a respeito da distribuição dos serviços de saúde e a correlação com os princípios de eficiência e equidade. Quando o sistema busca a otimização da eficiência, ele almeja que grande parte dos usuários seja provido por um determinado orçamento público, maximizando a distribuição dos serviços em determinado espaço geográfico.…”

“…Especialmente, a APS sofre importantes impactos das dificuldades estruturais e operacionais que comprometem seu papel de componente detentor de ferramentas estratégicas para a reorganização do sistema e de articulador com os demais componentes da RAS 18,29 . Sem condições materiais, tecnológicas e organizacionais para seu pleno funcionamento 15,29 , estudos apontaram que, segundo usuários e profissionais de saúde, a atenção primária apresenta resolutividade diminuída 21 , dificultando a disponibilidade de seus serviços aos usuários, bem como o alcance dos serviços de média e alta complexidade a partir de um fluxo formal de acesso 25 , visto que muitas vezes não possui a capacidade operacional para exercer seu papel de centro comunicador entre os pontos que compõem as complexas redes de cuidado 24,29 .…”

Calculation of turns costs in accessibility models. Case study: Manizales, Colombia

“…In this section, the method used to determine the prioritization of road intersections will be described. Five (5) different variables are studied, each of which will have a score from 1 to 10 as maximum score. In the end, each intersection will be able to obtain 50 as the maximum rating, making it more prone to the turn costs analysis by the grades that are closest to 50.…”

“…They also presented the different perspectives on which the accessibility measures are based: infrastructure, locations, people and utilities [15]. Accessibility models have been used over the years by different researchers in various topics such as: land use [38], transportation planning [17], social exclusion and accessibility [16], health facilities [5], location and supply of public bookstores [25]. In addition, in Manizales, different accessibility studies have been carried out, taking into account the turn costs, since 2011 in areas such as: health equipment [12], commercial [23,40], public bicycles and cycleroute network [4], impact of new transport infrastructures [22], among others After the introduction, the research methodology for the calculation of the turn costs for left and right in the city of Manizales is presented, followed by the presentation and discussion of results and the main conclusions of the investigation.…”

Comparison on Turn Costs in Accessibility Models. Case Study: Manizales, Colombia

“…In addition, Geurs and Ritsema van eck (2001) defined the different approaches and perspectives that this concept had, taking it to a new level in transport modeling. In addition, the different challenges and opportunities generated by the use of this model of supply to transport planners have been explored (Boisjoly & El-Geneidy, 2017;Geurs & Östh, 2016), reaching advances in various topics such as: equity in the transport (Guzman & Oviedo, 2018), accessibility to equipment such as hospitals (Cirino, Gonçalves, Gonçalves, & Souza De Cursi, 2018), parks (Wang, Brown, & Mateo-Babiano, 2013) and public bookstores (Park, 2012) , public transport (Curtis & Scheurer, 2015), among others. On the other hand, in the city of Manizales, accessibility measures have been frequently used for various urban planning issues, like to measure the impact of new road infrastructure projects (Moncada, Cardona, & Escobar, 2018;Perilla, Escobar, & Cardona, 2018), access to ambulance centers (Escobar, Holguín, & Zuluaga, 2016), public bicycle stations (Cardona, Zuluaga, & Escobar, 2017) and shopping centers (Zuluaga & Escobar, 2017), among others.…”