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Improving spatial accessibility to regional health systems through facility capacity management

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  • Bruno, Giuseppe
  • Cavola, Manuel
  • Diglio, Antonio
  • Piccolo, Carmela

Abstract

In austerity times, the general interest to reduce costs and improve efficiency levels often resulted into local cuts to public expenditure and profound reorganizations of existing service networks, especially in sectors like healthcare. In Italy, a recent reform prescribed the reconfiguration of time-dependent (i.e. emergency) hospital networks with the aim of improving patients’ accessibility conditions. In order to evaluate the impacts determined by this reorganization, we perform a spatial analysis in which we consider the distance from the closest facility as an accessibility measure. Results obtained from the spatial analysis confirm that users effectively benefit from the reorganization process but also that further improvements are possible, especially for the worst served ones. To this end, we also propose solving a mathematical programming model aiming at redistributing the capacities, i.e. the supply of beds, among the hospitals of the network seeking to maximize users’ accessibility. The realized computational experiments show that averagely better and even more equitable accessibility conditions could be obtained by containing the deriving reorganization costs.

Suggested Citation

  • Bruno, Giuseppe & Cavola, Manuel & Diglio, Antonio & Piccolo, Carmela, 2020. "Improving spatial accessibility to regional health systems through facility capacity management," Socio-Economic Planning Sciences, Elsevier, vol. 71(C).
    • Handle: RePEc:eee:soceps:v:71:y:2020:i:c:s0038012119305403
    DOI: 10.1016/j.seps.2020.100881
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    References listed on IDEAS

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    1. Guerriero, Francesca & Miglionico, Giovanna & Olivito, Filomena, 2016. "Location and reorganization problems: The Calabrian health care system case," European Journal of Operational Research, Elsevier, vol. 250(3), pages 939-954.
    2. Bruno, Giuseppe & Diglio, Antonio & Piccolo, Carmela & Cannavacciuolo, Lorella, 2019. "Territorial reorganization of regional blood management systems: Evidences from an Italian case study," Omega, Elsevier, vol. 89(C), pages 54-70.
    3. H K Smith & P R Harper & C N Potts, 2013. "Bicriteria efficiency/equity hierarchical location models for public service application," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 64(4), pages 500-512, April.
    4. Malczewski, Jacek & Jackson, Marlene, 2000. "Multicriteria spatial allocation of educational resources: an overview," Socio-Economic Planning Sciences, Elsevier, vol. 34(3), pages 219-235, September.
    5. Barbarisi, Ilaria & Bruno, Giuseppe & Diglio, Antonio & Elizalde, Javier & Piccolo, Carmela, 2019. "A spatial analysis to evaluate the impact of deregulation policies in the pharmacy sector: Evidence from the case of Navarre," Health Policy, Elsevier, vol. 123(11), pages 1108-1115.
    6. Burkey, M.L. & Bhadury, J. & Eiselt, H.A., 2012. "A location-based comparison of health care services in four U.S. states with efficiency and equity," Socio-Economic Planning Sciences, Elsevier, vol. 46(2), pages 157-163.
    7. E D Güneş & H Yaman & B Çekyay & V Verter, 2014. "Matching patient and physician preferences in designing a primary care facility network," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 65(4), pages 483-496, April.
    8. Neutens, Tijs, 2015. "Accessibility, equity and health care: review and research directions for transport geographers," Journal of Transport Geography, Elsevier, vol. 43(C), pages 14-27.
    9. E D Güneş & H Yaman, 2010. "Health network mergers and hospital re-planning," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 61(2), pages 275-283, February.
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    Cited by:

    1. Bruno, Giuseppe & Cavola, Manuel & Diglio, Antonio & Elizalde, Javier & Piccolo, Carmela, 2022. "A locational analysis of deregulation policies in the Spanish retail pharmaceutical sector," Socio-Economic Planning Sciences, Elsevier, vol. 82(PA).
    2. Zaharudin, Zati Aqmar & Brint, Andrew & Genovese, Andrea, 2022. "A multi-period model for reorganising urban household waste recycling networks," Socio-Economic Planning Sciences, Elsevier, vol. 84(C).
    3. Giuseppe Bruno & Manuel Cavola & Antonio Diglio & Carmela Piccolo, 2022. "Geographical accessibility to upper secondary education: an Italian regional case study," The Annals of Regional Science, Springer;Western Regional Science Association, vol. 69(2), pages 511-536, October.
    4. Mirosław Krzyśko & Waldemar Wołyńki & Marcin Szymkowiak & Andrzej Wojtyła, 2021. "A Spatio-Temporal Analysis of the Health Situation in Poland Based on Functional Discriminant Coordinates," IJERPH, MDPI, vol. 18(3), pages 1-17, January.
    5. Burdett, Robert L & Corry, Paul & Yarlagadda, Prasad & Cook, David & Birgan, Sean & McPhail, Steven M, 2023. "A mathematical framework for regional hospital case mix planning and capacity appraisal," Operations Research Perspectives, Elsevier, vol. 10(C).
    6. Bruno, Giuseppe & Cavola, Manuel & Diglio, Antonio & Piccolo, Carmela & Pipicelli, Eduardo, 2021. "Strategies to reduce postal network access points: from demographic to spatial distribution criteria," Utilities Policy, Elsevier, vol. 69(C).

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