An Efficient Decision-Making Approach for the Planning of Diagnostic Services in a Segmented Healthcare System

Abstract: In this paper, a problem related to a specialized diagnostic service that requires costly equipment in a segmented public healthcare system such as the one in Mexico is addressed. The aim is to determine which hospitals could provide the service and their capacity levels, the allocation of demand in each institution, and the reallocation of uncovered demand to other institutions or private sector providers while minimizing total annual cost of investment and operating cost required to satisfy all demand. A mixed integer linear programming model taking into account different characteristics such as patient acuity level, types of equipment, and demand variation through time is introduced. The model was empirically assessed to evaluate its impact in the decision-making process. Good quality solutions were found for instances up to 90 facilities. A sensitive analysis was performed to evaluate solution behavior for variations of critical parameters. It was found that some values could generate an effect in the total costs for the service coverage and in the efficiency of the service.