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Healthcare capacity shortage contributes to poor access in many countries. Moreover, rapid urbanization often occurring in these countries has exacerbated the imbalance between healthcare capacity and need. One way to address the above challenge is expanding the total capacity and redistributing the capacity spatially. In this research, we studied the problem of locating new hospitals in a two-tier outpatient care system comprising multiple central and district hospitals, and upgrading existing district hospitals to central hospitals. We formulated the problem with a discrete location optimization model. To parameterize the optimization model, we used a multinomial logit model to characterize individual patients’ diverse hospital choice and to quantify the patient arrival rates at each hospital accordingly. To solve the hard nonlinear combinatorial optimization problem, we developed a queueing network model to approximate the impact of hospital locations on patient flows. We then proposed a multi-fidelity optimization approach, which involves both the aforementioned queuing network model as a surrogate and a self-developed stochastic simulation as the high-fidelity model. With a real-world case study of Shanghai, we demonstrated the changes in the care network and examined the impacts on the network design by population center emergence, governmental budget change and considering patients with different age groups or income levels. Note to Practitioners —Our work focuses on improving system-wide care access in a two-tier care network. We believe that our work can lead to effective development of a location analytics tool for city-wide healthcare system planners. We also think the importance of this study is further strengthened by the case studies based on real-world hospital choice experimental data from Shanghai, China, a region suffering from the imbalance between healthcare capacity and need. Our case studies are expected to make recommendations on care facility expansion and dispersion to better align with the spatial distribution of residential communities and patient hospital choice behavior.
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A Pathfinding Algorithm for Lowering Infection Exposure of Healthcare Personnel Working in Makeshift Hospitals
Due to the recent COVID-19 outbreak, makeshift (MS) hospitals have become an important feature in healthcare systems worldwide. Healthcare personnel (HCP) need to be able to navigate quickly, effectively, and safely to help patients, while still maintaining their own well-being. In this study, a pathfinding algorithm to help HCP navigate through a hospital safely and effectively is developed and verified. Tests are run using a discretized 2D grid as a representation of an MS hospital plan, and total distance traveled and total exposure to disease are measured. The influence of the size of the 2D grid units, the shape of these units, and degrees of freedom in the potential movement of the HCP are investigated. The algorithms developed are designed to be used in MS hospitals where airborne illness is prevalent and could greatly reduce the risk of illness in HCP. In this study, it was found that the quantum-based algorithm would generate paths that accrued 50–66% less total disease quantum than the shortest path algorithm with also about a 33–50% increase in total distance traveled. It was also found that the mixed path algorithm-generated paths accrued 33–50% less quantum, but only increased total distance traveled by 10–20%.
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- Award ID(s):
- 1757659
- PAR ID:
- 10317211
- Date Published:
- Journal Name:
- Healthcare
- Volume:
- 10
- Issue:
- 2
- ISSN:
- 2227-9032
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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- Free Publicly Accessible Full Text
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Accepted Manuscript1.0
- Journal Article:
- https://doi.org/10.3390/healthcare10020344
