Planning health services with explicit geographical considerations: a stochastic location?allocation approach

Health network mergers and hospital re-planning

“…Verter and Lapierre (2002) model the problem of locating preventive health care facilities with the objective of maximizing participation, with the requirement of assigning more than a certain number of individuals to a facility because of quality concerns. Harper et al (2005) model a stochastic hospital planning problem with a discrete-event simulation approach. Güneş and Yaman (2005) study a problem similar to the one presented here, propose a model and present preliminary results for the case where only beds can be re-allocated.…”

Integrated decision making in healthcare : an operations research and management science perspective

“…To achieve this, local and regional bed occupancies need to be balanced with the local and regional probability of admission refusals resulting from a full census. The potential pitfall of deterministic approaches as used in [426] is that resource requirements are underestimated and thus false assurances are provided about the expected service level to patients [243]. Methods: computer simulation [243], mathematical programming [62,426], queueing theory [47].…”

“…Each care unit has its designated staff, equipment and beds (in one or more wards). The objective is to guarantee care from appropriately skilled nurses and required equipment to patients with specific diagnoses, while making efficient use of scarce resources [26,156,157,206,243,251,439,499]. First, the desirability of opening shared higher-level care units like Intensive Care Units (ICU) or Medium Care Units (MCU) should be considered [480].…”

“…Also, pooling gains should be weighed against possible extra costs for installing extra equipment on each bed [309]. To conclude, the question whether to consolidate or separate clinical services from a logistical point of view is one that should be answered for each specific situation, considering demand characteristics but also performance preferences and requirements [243]. Obviously, the care unit partitioning decision is highly interrelated with the capacity dimensioning decisions, to be discussed next.…”

“…Methods: computer simulation [156,157,206,243,259,439], heuristics [26,309,482], mathematical programming [376], queueing theory [217,251,355,359,360,480,522].…”