Specialty care single and multi-period location–allocation models within the Veterans Health Administration
Optimal location of specialty care services within any healthcare network is increasingly important for balancing costs, access to care, and patient-centeredness. Typical long-range planning efforts attempt to address a myriad of quantitative and qualitative issues, including within-network access within reasonable travel distances, space capacity constraints, costs, politics, and community commitments. To help inform these decisions, single and multi-period mathematical integer programs were developed that minimize total procedure, travel, non-coverage, and start-up costs to increase network capacity subject to access constraints. These models have been used to help the Veterans Health Administration (VHA) explore relationships and tradeoffs between costs, coverage, service location, and capacity and to inform larger strategic planning discussions. Results indicate significant opportunity to simultaneously reduce total cost, reduce total travel distances, and increase within-network access, the latter being linked to better care continuity and outcomes. An application to planning short and long-term sleep apnea care across the VHA New England integrated network, for example, produced 10–15% improvements in each performance measure. As an example of further insight provided by these analyses, most optimal solutions increase the amount of outside-network care, contrary to current trends and policies to reduce external referrals.
If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Klose, Andreas & Drexl, Andreas, 2005. "Facility location models for distribution system design," European Journal of Operational Research, Elsevier, vol. 162(1), pages 4-29, April.
- Harper, P. R. & Shahani, A. K. & Gallagher, J. E. & Bowie, C., 2005. "Planning health services with explicit geographical considerations: a stochastic location-allocation approach," Omega, Elsevier, vol. 33(2), pages 141-152, April.
- Murray Côté & Siddhartha Syam & W. Vogel & Diane Cowper, 2007. "A mixed integer programming model to locate traumatic brain injury treatment units in the Department of Veterans Affairs: a case study," Health Care Management Science, Springer, vol. 10(3), pages 253-267, September.
- Melachrinoudis, Emanuel & Min, Hokey, 2000. "The dynamic relocation and phase-out of a hybrid, two-echelon plant/warehousing facility: A multiple objective approach," European Journal of Operational Research, Elsevier, vol. 123(1), pages 1-15, May.
- Maria Bruni & Domenico Conforti & Nicola Sicilia & Sandro Trotta, 2006. "A new organ transplantation location–allocation policy: a case study of Italy," Health Care Management Science, Springer, vol. 9(2), pages 125-142, May.
- Aboolian, Robert & Sun, Yi & Koehler, Gary J., 2009. "A location-allocation problem for a web services provider in a competitive market," European Journal of Operational Research, Elsevier, vol. 194(1), pages 64-77, April.
- Owen, Susan Hesse & Daskin, Mark S., 1998. "Strategic facility location: A review," European Journal of Operational Research, Elsevier, vol. 111(3), pages 423-447, December.
- Syam, Siddhartha S. & Côté, Murray J., 2010. "A location-allocation model for service providers with application to not-for-profit health care organizations," Omega, Elsevier, vol. 38(3-4), pages 157-166, June.
- Murray, Alan T., 2001. "Strategic analysis of public transport coverage," Socio-Economic Planning Sciences, Elsevier, vol. 35(3), pages 175-188, September.
When requesting a correction, please mention this item's handle: RePEc:eee:soceps:v:46:y:2012:i:2:p:136-148. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu)
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.