- P-ISSN2287-1608
- E-ISSN2287-1616
- KCI
ISSN : 2287-1608
Restructuring Primary Health Care Network to Maximize Utilization and Reduce Patient Out-of-pocket Expenses
Amit Kumar Bardhan (University of Delhi)
Abstract
Providing free primary care to everyone is an important goal pursued by many countries under universal health care programs. Countries like India need to efficiently utilize their limited capacities towards this purpose. Unfortunately, due to a variety of reasons, patients incur substantial travel and out-of-pocket expenses for getting primary care from publicly-funded facilities. We propose a set-covering optimization model to assist health policy-makers in managing existing capacity in a better way. Decision-making should consider upgrading centers with better potential to reduce patient expenses and reallocating capacities from less preferred facilities. A multinomial logit choice model is used to predict the preferences. In this article, a brief background and literature survey along with the mixed integer linear programming (MILP) optimization model are presented. The working of the model is illustrated with the help of numerical experiments.
- keywords
- Facility location, primary care, public health, optimization, out-of-pocket expenses
Reference
Agarwal, R., Jain, P., Ghosh, M.S. and Parihar, K.S. (2017) Importance of primary health care in the society, International Journal of Health Sciences, 1(1), 6-11.
Antunes, A. and Peeters, D. (2001) On solving complex multi-period location models using simulated annealing, European Journal of Operational Research, 130(1), 190-201.
Araya, F., Dell, R., Donoso, P., Marianov, V., Mart´ınez, F. and Weintraub, A. (2012) Optimizing location and size of rural schools in chile, International Transactions in Operational Research, 19(5), 695-710.
Balarajan, Y., Selvaraj, S. and Subramanian, S. (2011) Health care and equity in India, The Lancet, 377(9764), 505-515.
Basar, A., Kabak, O¨. and Ilker Topcu, Y. (2017) A decision support methodology for locating bank branches: a case study in Turkey, International Journal of Information Technology & Decision Making, 16(01), 59-86.
Bruno, G., Genovese, A. and Piccolo, C. (2016) Capacity management in public service facility networks: a model, computational tests and a case study, Optimization Letters, 10(5), 975-995.
Dias, J., Captivo, M.E. and Cl´ımaco, J. (2006) Capacitated dynamic location problems with opening, closure and reopening of facilities, IMA Journal of Management Mathematics, 17(4), 317-348.
Garg, C.C. and Karan, A.K. (2008) Reducing out-of-pocket expenses to reduce poverty: a disaggregated analysis at rural-urban and state level in India, Health Policy and Planning, 24(2), 116-128.
Goli, S., Rammohan, A. and Pradhan, J., et al. (2016) High spending on maternity care in India: what are the factors explaining it?, PlOS ONE, 11(6), e0156437.
Graber-Naidich, A., Carter, M.W. and Verter, V. (2017) Restructuring the resident training system for improving the equity of access to primary care, European Journal of Operational Research, 258(3), 1143-1155.
Guerriero, F., Miglionico, G. and Olivito, F. (2016) Location and reorganization problems: the Calabrian health care system case, European Journal of Operational Research, 250(3), 939-954.
Hamid, S.A., Ahsan, S.M. and Begum, A. (2014) Disease-specific impoverishment impact of out-of- pocket payments for health care: evidence from rural Bangladesh, Applied Health Economics and Health Policy, 12(4), 421-433.
Jena, S.D., Cordeau, J.F. and Gendron, B. (2015a) Dynamic facility location with generalized modular capacities, Transportation Science, 49(3), 484-499.
Jena, S.D., Cordeau, J.F. and Gendron, B. (2015b) Modeling and solving a logging camp location problem, Annals of Operations Research, 232(1), 151-177.
Jena, S.D., Cordeau, J.F. and Gendron, B. (2016) Solving a dynamic facility location problem with partial closing and reopening, Computers & Operations Research, 67, 143-154.
Kumar, A.S., Chen, L.C., Choudhury, M., Ganju, S., Mahajan, V., Sinha, A. and Sen, A. (2011) Financing health care for all: challenges and opportunities, The Lancet, 377(9766), 668-679.
Ladusingh, L., Mohanty, S. K. and Thangjam, M. (2018) Triple burden of disease and out of pocket healthcare expenditure of women in India, PlOS ONE, 13(5), e0196835.
Monteiro, M.S.R. and Fontes, D.B. (2006) Locating and sizing bank-branches by opening, closing or maintaining facilities, Operations Research Proceedings 2005, 303-308, Springer.
Moore, G.C. and ReVelle, C. (1982) The hierarchical service location problem, Management Science, 28(7), 775-780.
NHSRC (2017) National Health Accounts Estimates for India (2014-15) Technical Report, Ministry of Health and Family Welfare, Government of India.
Powell-Jackson, T., Acharya, A.and Mills, A. (2013) An assessment of the quality of primary health care in India, Economic and Political Weekly, 48(19), 53-61.
Rao, M. and Mant, D. (2012) Strengthening primary healthcare in India: white paper on opportunities for partnership, British Medical Journal, 344, e3151.
Ratick, S.J., Osleeb, J.P. and Hozumi, D. (2009) Application and extension of the Moore and Revelle hierarchical maximal covering model, Socio-Economic Planning Sciences, 43(2), 92-101.
Ruiz-Herna´ndez, D. (2014) Capacitated delocation models for closing and resizing redundant branches, Colegio Universitario de Estudios Financieros, Research gate.
Ruiz-Herna´ndez, D., Delgado-Go´mez, D. and Lo´pez-Pascual, J. (2015) Restructuring bank networks after mergers and acquisitions: a capacitated delocation model for closing and resizing branches, Computers & Operations Research, 62, 316-324.
Saksena, P., Xu, K., Elovainio, R. and Perrot, J. (2010) Health services utilization and out-of-pocket expenditure at public and private facilities in low-income countries, World Health Report, 20, 20.
Salazar, M., Vora, K. and De Costa, A. (2016) Bypassing health facilities for childbirth: a multilevel study in three districts of Gujarat, India, Global Health Action, 9(1), 32178.
Sangar, S., Dutt, V. and Thakur, R. (2018) Economic burden, impoverishment and coping mechanisms associated with out-of-pocket health expenditure: analysis of rural-urban differentials in India, Journal of Public Health, 1-10.
Sohrabi, M. and Tumin, M. (2016) Health issues and challenges among Indian urban poor, Journal of Health Management, 18(3), 460-472.
Wang, Q., Batta, R., Bhadury, J. and Rump, C.M. (2003) Budget constrained location problem with opening and closing of facilities, Computers & Operations Research, 30(13), 2047-2069.
Zhang, Y., Berman, O. and Verter, V. (2012) The impact of client choice on preventive healthcare facility network design, OR Spectrum, 34(2), 349-370.
Zhang, Y., Liang, L., Liu, E., Chen, C. and Atkins, D. (2016) Patient choice analysis and demand prediction for a health care diagnostics company, European Journal of Operational Research, 251(1), 198-205.
- Downloaded
- Viewed
- 0KCI Citations
- 0WOS Citations