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In-Depth Information
call and the delivery of the patient to an appropriate health service provider. We
devote Sect.
21.3
to ambulance location problems which integrate aspects from
covering location models, multi-period location models, and location problems
under uncertainty. In these problems, the influence of local law regulation on
constraints and objective functions is quite remarkable as well. The third and last
topic we are dealing with in this chapter concerns layout problems in hospitals. As a
result of a good layout, hospitals prepare themselves for changes in the structure of
patient groups and the mix of medical cases as well as for a trend from surgery-
centered care to chronic disease care. In Sect.
21.4
, basic models are presented
and modern trends are discussed, such as the inclusion of multiple floors, multiple
objectives or uncertainty. At the end of this chapter, the reader will find some
conclusions and a comprehensive list of references.
21.2
Healthcare Facility Location
In this section, we focus on applications of discrete network location problems
to health facilities. Such facilities involve community health clinics, primary care
centers, public and private hospitals, or specialized clinics. The problems are
therefore closely related to public facility location. We do not discuss continuous
location models. In the literature, there are only a few papers applying such models;
see, e.g., Dokmeci (
1977
,
1979
).
Location of healthcare facilities can be a critical decision for developing
countries since they have scarce resources and the majority of their population living
in rural areas. The low population density in these regions makes the provision
of health services a challenge. Within this context, location-allocation models can
therefore be successfully applied for the design of health facility networks. One
of the earliest applications is due to Gould and Leinbach (
1966
) who considered
locating hospitals and determining their capacities in Western Guatemala. For an
extensive review of such applications, see Rahman and Smith (
2000
); for a review
on healthcare facility location problems, see Daskin and Dean (
2004
).
In the following, we give an overview of health facility location applications
by first discussing the relevant objective functions and then presenting important
aspects of these problems with examples from the literature.
21.2.1
Objective Functions in Healthcare Facility Location
Healthcare facility location problems are inherently multi-objective since there are
different stakeholders and the facilities are predominantly public. The decisions
affect health consumers and healthcare providers as well as the public community.
These three sectors can have different priorities and utility functions. For example,
consumers are influenced by the travel cost and time, quality of service, comfort and
