Modeling hospital infrastructure by optimizing quality, accessibility and efficiency via a mixed integer programming model.
Background: The majority of curative health care is organized in hospitals. As in most other countries, the current 94 hospital locations in the Netherlands offer almost all treatments, ranging from rather basic to very complex care. Recent studies show that concentration of care can lead to substan...
| Published in: | BMC Health Services Research Vol. 13; no. 1; pp. 220 - 221 |
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| Main Authors: | , , , , |
| Format: | research Journal Article |
| Published: |
BioMed Central
2013
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104165157&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104165157 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14726963 1CHS jtl: BMC Health Services Research issn: 14726963 maglogo: N pubinfo: dt: 2013 vid: 13 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 104165157 104165157 NLM23768234 2012280929 10.1186/1472-6963-13-220 NLM23768234 PMC3698106 104165157 ppf: 220 ppct: 1 formats: tig: atl: Modeling hospital infrastructure by optimizing quality, accessibility and efficiency via a mixed integer programming model. aug: au: Ikkersheim, David Tanke, Marit van Schooten, Gwendy de Bresser, Niels Fleuren, Hein affil: KPMG Plexus, Breukelen, The Netherlands. Ikkersheim.david@kpmgplexus.nl sug: subj: Diagnosis-Related Groups Statistics and Numerical Data Organizational Efficiency Health Services Accessibility Standards Hospitals Standards Quality Improvement Chronic Disease Classification Computer Simulation Hospitals Statistics and Numerical Data Hospitals, Special Human International Classification of Diseases Models, Theoretical Netherlands Quality of Health Care Software ab: Background: The majority of curative health care is organized in hospitals. As in most other countries, the current 94 hospital locations in the Netherlands offer almost all treatments, ranging from rather basic to very complex care. Recent studies show that concentration of care can lead to substantial quality improvements for complex conditions and that dispersion of care for chronic conditions may increase quality of care. In previous studies on allocation of hospital infrastructure, the allocation is usually only based on accessibility and/or efficiency of hospital care. In this paper, we explore the possibilities to include a quality function in the objective function, to give global directions to how the 'optimal' hospital infrastructure would be in the Dutch context.Methods: To create optimal societal value we have used a mathematical mixed integer programming (MIP) model that balances quality, efficiency and accessibility of care for 30 ICD-9 diagnosis groups. Typical aspects that are taken into account are the volume-outcome relationship, the maximum accepted travel times for diagnosis groups that may need emergency treatment and the minimum use of facilities.Results: The optimal number of hospital locations per diagnosis group varies from 12-14 locations for diagnosis groups which have a strong volume-outcome relationship, such as neoplasms, to 150 locations for chronic diagnosis groups such as diabetes and chronic obstructive pulmonary disease (COPD).Conclusions: In conclusion, our study shows a new approach for allocating hospital infrastructure over a country or certain region that includes quality of care in relation to volume per provider that can be used in various countries or regions. In addition, our model shows that within the Dutch context chronic care may be too concentrated and complex and/or acute care may be too dispersed. Our approach can relatively easily be adopted towards other countries or regions and is very suitable to perform a 'what-if' analysis. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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