Faculty of Management, University of Primorska, Izolska Vrata 2, SI-6000 Koper, Slovenia.
Int J Environ Res Public Health. 2023 Feb 27;20(5):4235. doi: 10.3390/ijerph20054235.
This article explores how the minimum number of general hospital locations can be determined with optimal population coverage. Due to the increasing financial problems of hospitals and the poor organization of general hospital healthcare, Slovenia is currently working to reform the healthcare system. Defining the optimal network of hospital providers is one of the key elements in reforming the healthcare system. To define the optimal network of general hospitals, the allocation-location model was used, and the maximize attendance model was used as the central method. The chief purpose of maximize attendance model is to optimize the demand attendance with respect to distance and time spent getting to the point of demand. In the analysis of optimal locations and the number of Slovenian general hospitals, we used data on the locations of settlements with their number of inhabitants and data on the Slovenian road network, based on which we defined average travel speeds on the categorized road network. The hypothetical locations of general hospitals and the number of optimally located general hospitals that provide access to the nearest provider were determined in three different time intervals. We found that the same accessibility to hospital services as provided by the existing network of general hospitals can be achieved with only ten optimally located general hospitals within a 30-min time interval. This means that two general hospitals could be rationalized or reorganized, which would bring significant savings in the field of hospital activity, which creates a large loss in the health system in Slovenia.
本文探讨了如何以最优的人口覆盖范围确定最少的综合医院数量。由于医院财务问题不断增加和综合医院医疗服务组织不善,斯洛文尼亚目前正在努力改革医疗体系。确定医院供应商的最佳网络是医疗体系改革的关键要素之一。为了定义一般医院的最佳网络,使用了分配-位置模型,并将最大化就诊模型用作核心方法。最大化就诊模型的主要目的是优化相对于距离和就诊点之间的时间花费的需求就诊。在分析斯洛文尼亚综合医院的最佳位置和数量时,我们使用了有关居民数量的定居点位置的数据以及基于该数据的斯洛文尼亚道路网络数据,在此基础上,我们定义了分类道路网络上的平均行驶速度。在三个不同的时间间隔内,确定了一般医院的假设位置和提供最近提供者服务的最佳位置的一般医院数量。我们发现,仅在 30 分钟的时间间隔内,通过十个最佳位置的综合医院,就可以实现与现有综合医院网络相同的医院服务可及性。这意味着可以合理化或重组两家综合医院,这将在医院活动领域带来重大节省,这对斯洛文尼亚的卫生系统造成了巨大损失。