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Specialty care single and multi-period location–allocation models within the Veterans Health Administration

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  • Benneyan, James C.
  • Musdal, Hande
  • Ceyhan, Mehmet Erkan
  • Shiner, Brian
  • Watts, Bradley V.

Abstract

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.

Suggested Citation

  • Benneyan, James C. & Musdal, Hande & Ceyhan, Mehmet Erkan & Shiner, Brian & Watts, Bradley V., 2012. "Specialty care single and multi-period location–allocation models within the Veterans Health Administration," Socio-Economic Planning Sciences, Elsevier, vol. 46(2), pages 136-148.
  • Handle: RePEc:eee:soceps:v:46:y:2012:i:2:p:136-148
    DOI: 10.1016/j.seps.2011.12.005
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    References listed on IDEAS

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    Cited by:

    1. repec:eee:transe:v:111:y:2018:i:c:p:113-129 is not listed on IDEAS
    2. Qin, Hong & Prybutok, Victor R., 2013. "A quantitative model for patient behavioral decisions in the urgent care industry," Socio-Economic Planning Sciences, Elsevier, vol. 47(1), pages 50-64.
    3. Zahiri, B. & Tavakkoli-Moghaddam, R. & Mohammadi, M. & Jula, P., 2014. "Multi-objective design of an organ transplant network under uncertainty," Transportation Research Part E: Logistics and Transportation Review, Elsevier, vol. 72(C), pages 101-124.
    4. Cardoso, Teresa & Oliveira, Mónica Duarte & Barbosa-Póvoa, Ana & Nickel, Stefan, 2016. "Moving towards an equitable long-term care network: A multi-objective and multi-period planning approach," Omega, Elsevier, vol. 58(C), pages 69-85.
    5. Zeinal Hamadani, Ali & Abouei Ardakan, Mostafa & Rezvan, Taghi & Honarmandian, Mohammad Mehran, 2013. "Location-allocation problem for intra-transportation system in a big company by using meta-heuristic algorithm," Socio-Economic Planning Sciences, Elsevier, vol. 47(4), pages 309-317.
    6. repec:kap:hcarem:v:20:y:2017:i:4:d:10.1007_s10729-016-9366-2 is not listed on IDEAS
    7. repec:spr:orspec:v:40:y:2018:i:3:d:10.1007_s00291-018-0519-1 is not listed on IDEAS
    8. Mohammadi, M. & Dehbari, S. & Vahdani, Behnam, 2014. "Design of a bi-objective reliable healthcare network with finite capacity queue under service covering uncertainty," Transportation Research Part E: Logistics and Transportation Review, Elsevier, vol. 72(C), pages 15-41.

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