Universidade Católica Portuguesa, Católica Porto Business School, Centro de Estudos em Gestão e Economia, Porto, Portugal.
SDA Bocconi, School of Management, Milano, Italy.
J Health Popul Nutr. 2024 Jul 5;43(1):102. doi: 10.1186/s41043-024-00594-4.
Balancing is an essential challenge in healthcare systems that requires effective strategies. This study aims to address this crucial issue by suggesting a practical approach. We show the potential of balancing a regional healthcare system to improve its utility. We consider a regional healthcare system comprising multiple hospitals with different sizes, capacities, quality of service, and accessibility. We define a utility function for the system based on the sectorization concept, which endeavors to form a balance between hospitals in terms of essential outputs such as waiting times and demands. The dynamic nature of the system means that this balance degrades over time, necessitating periodic sectorization, which is called resectorization. Our methodology stands out for incorporating resectorization as a dynamic strategy, enabling more flexible and responsive adaptations to continuously changing healthcare needs. Unlike previous studies, based on a system-oriented approach, our resectorization scenarios include the periodic closure of some hospitals. This enables us to enhance both the capacity and quality of healthcare facilities. Furthermore, in contrast to other studies, we investigate the states of diminishing demand throughout the resectorization process. To provide empirical insights, we conduct a simulation using data from a real-world case study. Our analysis spans multiple time periods, enabling us to dynamically quantify the utility of the healthcare system. The numerical findings demonstrate that substantial utility improvements are attainable through the defined scenarios. The study suggests a practical solution to the critical challenge of balancing issues in regional healthcare systems.
平衡是医疗保健系统中的一个基本挑战，需要有效的策略。本研究旨在通过提出一种实用的方法来解决这个关键问题。我们展示了平衡区域医疗保健系统以提高其效用的潜力。我们考虑了一个由多个具有不同规模、容量、服务质量和可及性的医院组成的区域医疗保健系统。我们基于分区化概念为系统定义了一个效用函数，该概念旨在根据等待时间和需求等基本产出在医院之间形成平衡。系统的动态性质意味着这种平衡会随着时间的推移而恶化，因此需要定期分区化，即重新分区。我们的方法的突出特点是将重新分区作为一种动态策略，能够更灵活和响应地适应不断变化的医疗保健需求。与基于系统导向的方法的先前研究不同，我们的重新分区方案包括定期关闭一些医院。这使我们能够提高医疗设施的容量和质量。此外，与其他研究不同，我们在重新分区过程中研究了需求减少的状态。为了提供实证见解，我们使用来自实际案例研究的数据进行了模拟。我们的分析跨越多个时间段，使我们能够动态量化医疗保健系统的效用。数值结果表明，通过定义的方案可以实现可观的效用改进。该研究为平衡区域医疗保健系统中的问题提供了一种实用的解决方案。
