Preventive healthcare facility location planning with quality-conscious clients
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Preventive healthcare facility location planning with quality‑conscious clients Ralf Krohn1 · Sven Müller2 · Knut Haase1 Received: 13 July 2018 / Accepted: 18 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Pursuing the overarching goal of saving both lives and healthcare costs, we introduce an approach to increase the expected participation in a preventive healthcare program, e.g., breast cancer screening. In contrast to sick people who need urgent medical attention, the clients in preventive healthcare decide whether to go to a specific facility (if this maximizes their utility) or not to take part in the program. We consider clients’ utility functions to include decision variables denoting the waiting time for an appointment and the quality of care. Both variables are defined as functions of a facility’s utilization. We employ a segmentation approach to formulate a mixed-integer linear program. Applying GAMS/CPLEX, we optimally solved instances with up to 400 demand nodes and 15 candidate locations based on both artificial data as well as in the context of a case study based on empirical data within one hour. We found that using a Benders decomposition of our problem decreases computational effort by more than 50%. We observe a nonlinear relationship between participation and the number of established facilities. The sensitivity analysis of the utility weights provides evidence on the optimal participation given a specific application (data set, empirical findings). Keywords Discrete choice · Healthcare · Random utility · Configurations of facilities · Facility location · Benders
* Ralf Krohn ralf.krohn@uni‑hamburg.de Sven Müller [email protected] Knut Haase knut.haase@uni‑hamburg.de 1
Faculty of Business Administration (HBS – Hamburg Business School), Institute of Transport Economics, Universität Hamburg, Moorweidenstraße 18, 20148 Hamburg, Germany
2
Center of Operations Research and Business Analytics, Otto-von-Guericke-University, Universitätsplatz 2, 39106 Magdeburg, Germany
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1 Introduction Preventive healthcare is beneficial to society because it facilitates early detections of diseases and helps to interrupt its development, which is less costly and harmful than curing diseases at advanced stages (Güneş et al. 2015). Established preventive healthcare programs (e.g., breast or colorectal cancer screenings) help to increase the number of early detections (Madadi et al. 2015). To save both lives and potential medical treatment costs, policy makers aim at raising participation in preventive healthcare programs (BreastScreen Australia 2015). Whereas patients have little influence on where they get medical help in urgent cases, preventive measures can be planned and allow for patients’ choices. Empirical studies show that accessibility is a significant factor that drives people’s participation. The location of facilities is decisive: Our objective is to develop a methodology to set up a limited number of facilities so t
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