Medical centers location and specialists’ allocation: a healthcare planning case study

Abstract Paper aims To set the locations of new medical centers to meet the population’s secondary care needs, the additional number of specialists, equipment, and an installation sequence at municipalities. Originality We developed descriptive cost functions models and adopted aggregate data from official sources to set parameters of an integrated MILP model. Research method A case study at the Brazilian state of Minas Gerais. Main findings For every scenario, the recommended locations set centers dispersed over the state area, in cities with the minimum required infrastructure. We also propose a scenario of secondary care network re-design and demonstrate the reduced cost of such a strategy. Implications for theory and practice To automate the decision process, we developed a web-based system, providing flexibility and scientific-based results. Finally, we propose a sequence for installing 43 new medical centers and improving the capacity of 27 existing infrastructure based on equality principles.

摘要 研究目标：为满足人口的二级医疗服务需求，确定新建医疗中心的选址、所需新增的专科医师人数与设备配置，以及各市政单位的医疗中心安装时序。
创新性：本研究构建了描述性成本函数模型，并采用官方来源的汇总数据为集成混合整数线性规划（Mixed Integer Linear Programming, MILP）模型设定参数。
研究方法：以巴西米纳斯吉拉斯州为案例研究区域。
主要研究发现：在所有模拟场景中，推荐的选址方案均为该州境内具备最低必要基础设施的城市，医疗中心布局呈分散化特征。本研究同时提出了二级医疗服务网络重构方案，并验证了该策略可有效降低成本。
理论与实践启示：为实现决策流程自动化，本研究开发了一套基于网页的系统，可提供灵活且具备科学依据的决策结果。最后，本研究基于公平性原则，提出了新建43所医疗中心并升级27处现有基础设施服务容量的安装时序方案。