Regionalization of Primary Health Care Units with Multi-Institutional Collaboration

Abstract: In this paper, the problem of locating and upgrading primary healthcare units within a multi-institutional public system is addressed. The problem is motivated by a real-world application in the Mexican Healthcare System. Decisions also involve allocating customer demand to those facilities with the goal of minimizing the total travel distance in a capacitated facility location problem. The capacity is measured in units named basic kernels composed by a group of medical staff for outpatient services. A mixed-integer linear programming model is proposed. A computational study based on a case study in the State of Mexico is carried out. Test instances are successfully solved by branch and bound. The distribution of patient-to-healthcare unit distances and the variation of the capacity utilization rate of health care units are analyzed. Among the results, we found that balancing the utilization rates between healthcare units has a negative impact on the total travel distance. The capacity of a kernel can be modified to balance the utilization rates or when the demand is greater than the capacity in the system. The results presented in this paper open the opportunity of using OR tools in the planning of healthcare resources in developing countries to face the challenges of the next decade in health matters.