Optimal Longitudinal Relocation of Colonoscopy Services within the Veterans Health Administration

摘要

Location-allocation models in any healthcare organization can play an important role in improving access and costs. This paper is concerned with optimal location of colonoscopy screening services, one of the highly demanded specialty care services across Veterans Health Administration's New England integrated health network. Two mathematical models, a single-period and a multi-period model, are developed to find optimal locations for additional facilities, capacities for current and additional facilities, and allocation of patients to these facilities. The performance of the system is measured by total operation, travel, non-coverage, start-up, underutilization, and capacity expansion costs. Alternate scenarios are developed based on variables such as coverage, demand, distance, and number of additional facilities. Results indicate that reducing the cost and increasing the accessibility by 10-15% is possible. Moreover the advantages of long term planning are demonstrated by analyzing the differences between the multi period and single period cases. Multi period model results appeared to lead to $633,674 more annual savings on average.